Systematic review of intraperitoneal chemotherapy for gastric cancer

Matharu, Gulraj S.; Tucker, Olga; Alderson, Derek

doi:10.1002/bjs.7586

Cited by 35 publications

(26 citation statements)

References 47 publications

(136 reference statements)

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“…QoL was assessed by KPS improvement rate (KPS IR) and pain according to the KPS IR criteria (20) as follows: (i) Improvement was defined as a KPS increase of ≥10% after treatment; (ii) worsening was defined as a KPS reduction of ≥10% after treatment; and (iii) NC was defined as a change in KPS of <10%.…”

Section: Adjustment: Addition Of Polyporus Umbellatus (Pers) Fr (15 mentioning

confidence: 99%

“…Although IPCP/CRPE appears to be superior to IPCI, it is a difficult, high-risk and costly procedure. Furthermore, there are not sufficient data to conclude on IPCP feasibility in this combination (20). Hyperthermic intraperitoneal chemoperfusion (HIPEC) appears to be the most commonly used IPCP method providing better survival times, although it is currently not recommended as a standard-of-care option due to the controversy surrounding its use (21).…”

Section: Introductionmentioning

confidence: 99%

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Local modulated electro-hyperthermia in combination with traditional Chinese medicine vs. intraperitoneal chemoinfusion for the treatment of peritoneal carcinomatosis with malignant ascites: A phase II randomized trial

Pang¹,

Zhang²,

Wang³

et al. 2017

Molecular and Clinical Oncology

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Abstract. The purpose of this study was to develop a safe and non-toxic alternative to the conventional conservative treatment of peritoneal carcinomatosis with malignant ascites (PCMA) by investigating the efficacy and safety of local modulated electro-hyperthermia (mEHT) combined with the traditional Chinese medicine (TCM) 'Shi Pi' herbal decoction, compared with standard intraperitoneal chemoinfusion (IPCI). A randomized, controlled, single-center, open-label clinical trial (phase II) with two parallel groups (allocation ratio, 1:1) was conducted to investigate the efficacy and safety of mEHT+TCM (study group, SG) vs. standard IPCI (control group, CG) in patients with PCMA by intention-to-treat analysis. A total of 260 patients with PCMA were randomly allocated into the two groups (130/130); mEHT was applied for 60 min per session every second day for 4 weeks, for a total of 14 sessions. The TCM decoction was administered orally, at 400 ml daily. In CG, occlusive IPCI with cisplatin (30-60 mg) and fluorouracil (500-600 mg/m 2 ) was applied twice, biweekly. The objective response rate (ORR), quality of life (QoL) and adverse event rate (AER) in the two groups were evaluated 1 month after treatment, analyzed and compared. The present study is registered on ClinicalTrials.gov (NCT02638051). No case was lost or excluded (0/260). The ORR in SG was 77.69% (101/130) vs. 63.85% (73/130) in CG (P<0.05). The QoL in SG was 49.23% vs. 32.3% in CG (P<0.05). The AER in SG was 2.3% (3/130) vs. 12.3% (16/130) in CG (P<0.05). All the adverse events were grade I. In conclusion, the combination of mEHT with TCM achieves better control of PCMA compared with standard IPCI, with less toxicity. Both components of the combination are non-toxic treatments easily tolerated by patients. Thus, this combined treatment may be preferred due to the better benefit-harm balance.

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Section: Adjustment: Addition Of Polyporus Umbellatus (Pers) Fr (15 mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Local modulated electro-hyperthermia in combination with traditional Chinese medicine vs. intraperitoneal chemoinfusion for the treatment of peritoneal carcinomatosis with malignant ascites: A phase II randomized trial

Pang¹,

Zhang²,

Wang³

et al. 2017

Molecular and Clinical Oncology

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“…Adjuvant SCT has not become the standard of care for gastric cancer except with S1 in Japan following the publication of the results of the ACTS-GC trial (6,16). In addition, there is limited good quality evidence to determine the role of adjuvant IPCT in gastric cancer (17). The optimal adjuvant chemotherapy approach for gastric cancer such as SCT, IPCT alone or in combination has not yet been well-defined and there is no widely accepted chemotherapeutic regimen.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant combined systemic chemotherapy and intraperitoneal chemotherapy for locally advanced gastric cancer

Xue

et al. 2012

Oncology Letters

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Abstract. The optimal adjuvant treatment modality for gastric cancer has not been well defined. The aim of this study was to evaluate the efficacy and feasibility of adjuvant combined systemic and intraperitoneal chemotherapy (ACSIP) in high-risk patients with locally advanced gastric 2 on day 5. Survival rates, the sites of first treatment failure and safety were analyzed. At a median follow-up of 45 months (range 7-101), the 3-year disease-free survival (DFS) and overall survival (OS) rates were 66.1 and 74.2%, respectively. Initial peritoneal and hepatic failures were found in 6 (24.0%) and 3 (12.0%) of the 25 patients with recurrence, respectively. Neutropenia, gastrointestinal side effects and peripheral neuropathy were the most common grade 3-4 toxicities; however, they were all infrequent and manageable. No serious surgical complications or treatment-related mortality was observed. The results of this study indicate that ACSIP is effective and feasible for locally advanced gastric cancer with encouraging survival rates and possibly decreased peritoneal and hepatic recurrences. The benefits of this promising combined adjuvant treatment modality warrant further studies.

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“…Treatments such as i.p. chemotherapy44 and hyperthermic i.p. effusion chemotherapy (HIPEC) could add further impact, and some clinical trials exploring preoperative HIPEC by the laparoscopic approach45 and HIPEC at the time of gastrectomy46 have been conducted for the CY1 population.…”

Section: Peritoneal Metastasismentioning

confidence: 99%

Surgery with curative intent for stage IV gastric cancer: Is it a reality of illusion?

Kodera

2018

Annals of Gastroent Surgery

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Gastric cancer with metastases outside of the regional lymph nodes is deemed oncologically unresectable. Nevertheless, some metastatic lesions are technically resectable by applying established surgical techniques such as para‐aortic lymphadenectomy and hepatectomy. At the time of compilation of the Japanese gastric cancer treatment guidelines version 4, systematic reviews were conducted to see whether it is feasible to make any recommendation to dissect both the primary and metastatic lesions with intent to cure, possibly as part of multimodality treatment. Long‐term survivors were found among carefully selected groups of patients both in prospective and retrospective studies. In addition, there is a growing list of publications reporting encouraging outcomes of gastrectomy conducted after exceptionally good response to chemotherapy, usually among patients who underwent R0 resection. This type of surgery is often referred to as conversion surgery. It is sometimes difficult to define a clear borderline between curative surgery scheduled after neoadjuvant chemotherapy and the conversion surgery. This review summarizes what we knew after the literature reviews conducted at the time of compiling the Japanese guidelines and in addition reflects some new findings obtained thereafter through clinical trials and retrospective studies. Metastases were divided into three categories based on the major metastatic pathways: lymphatic, hematogenous, and peritoneal. In each of these categories, there were findings that could provide hope for patients with metastatic disease. These findings implied that the surgical technique that we already use could become more useful upon further developments in antineoplastic agents and drug delivery.

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Systematic review of intraperitoneal chemotherapy for gastric cancer

Cited by 35 publications

References 47 publications

Local modulated electro-hyperthermia in combination with traditional Chinese medicine vs. intraperitoneal chemoinfusion for the treatment of peritoneal carcinomatosis with malignant ascites: A phase II randomized trial

Local modulated electro-hyperthermia in combination with traditional Chinese medicine vs. intraperitoneal chemoinfusion for the treatment of peritoneal carcinomatosis with malignant ascites: A phase II randomized trial

Adjuvant combined systemic chemotherapy and intraperitoneal chemotherapy for locally advanced gastric cancer

Surgery with curative intent for stage IV gastric cancer: Is it a reality of illusion?

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