Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy with lobaplatin and docetaxel to treat synchronous peritoneal carcinomatosis from gastric cancer: Results from a Chinese center

Eur J Surg Oncol. 2016 Jul;42(7):1024-34. doi: 10.1016/j.ejso.2016.04.053. Epub 2016 May 3.

Abstract

Background: This work was to evaluate the efficacy and safety of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) with lobaplatin and docetaxel to treat peritoneal carcinomatosis (PC) from gastric cancer (GC).

Methods: A total of 50 consecutive GC PC patients treated by 52 CRS+HIPEC procedures with lobaplatin 50 mg/m(2) and docetaxel 60 mg/m(2) in 6000 mL of normal saline at (43 ± 0.5) °C for 60 min. The primary endpoint was overall survival (OS), and the secondary endpoints were perioperative safety profiles.

Results: At the median follow-up of 22.5 (range, 5.1-50.7) months, the median OS was 14.3 (95% CI 7.6-21.0) months, and the 1-, 2-, and 3-year survival rates were 58%, 40%, and 32%, respectively. Mortality and serious adverse event (grade 3-5) morbidity rates in postoperative 30 days were 0.0% and 23.1%, respectively. Univariate analysis identified 4 parameters with significant effects on OS: completeness of cytoreduction (CC) 0-1, normal (N) the preoperative tumor markers level (TM), adjuvant chemotherapy ≥6 cycles, and peritoneal cancer index ≤20. However, multivariate analysis identified CC0-1, perioperative TM (N), adjuvant chemotherapy ≥6 cycles as the independent predictor for better survival.

Conclusions: CRS+HIPEC with lobaplatin and docetaxel to treat selected GC PC could improve OS, with acceptable perioperative safety.

Keywords: Cytoreductive surgery; Docetaxel; Gastric cancer; Hyperthermic intraperitoneal chemotherapy; Lobaplatin; Synchronous peritoneal carcinomatosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma / drug therapy*
  • Carcinoma / mortality
  • Carcinoma / secondary
  • Carcinoma / surgery*
  • Chemotherapy, Cancer, Regional Perfusion*
  • China
  • Cyclobutanes / administration & dosage
  • Cytoreduction Surgical Procedures*
  • Databases, Factual
  • Docetaxel
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced*
  • Kaplan-Meier Estimate
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Neoplasms, Multiple Primary / drug therapy*
  • Neoplasms, Multiple Primary / mortality
  • Neoplasms, Multiple Primary / surgery*
  • Organoplatinum Compounds / administration & dosage
  • Peritoneal Neoplasms / drug therapy*
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / secondary
  • Peritoneal Neoplasms / surgery*
  • Prognosis
  • Retrospective Studies
  • Sample Size
  • Stomach Neoplasms / pathology*
  • Taxoids / administration & dosage
  • Treatment Outcome

Substances

  • Cyclobutanes
  • Organoplatinum Compounds
  • Taxoids
  • Docetaxel
  • lobaplatin