Clinical effect of intraperitoneal perfusion of verapamil and chemotherapeutic drugs on treating patients with gastric cancer after operation
10.7619/jcmp.201803001
- VernacularTitle:胃癌术后腹腔灌注维拉帕米联合化疗药物的临床效果研究
- Author:
Guohong YANG
1
;
Gaofei FAN
;
Yang WU
;
Yabei LIU
;
Jin HUANG
;
Pingsheng FAN
Author Information
1. 山东大学医学院
- Keywords:
gastric cancer;
intraperitoneal perfusion;
chemotherapy;
verapamil;
drug resistance;
5-fluorouracil;
cisplatin;
leucovorin
- From:
Journal of Clinical Medicine in Practice
2018;22(3):1-8
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical efficacy and side effects of intraperitoneal perfusion of verapamil and chemotherapeutic drugs in treating patients with gastric cancer after operation.Methods Totally 184 gastric cancer patients accepted radical surgery with postoperative classification (pT1/2/3/4N2/3M0) were randomly divided into control group (n =58) and treatment group (n =126).For the post-gastrectomy chemotherapeuric treatment,1 g of 5-fluorouracil and 70 to 90 mg of cisplatin were administrated for the patients in the control group,while 1 g of 5-fluorouracil,70 to 90 mg of cisplatin and 25 mg of verapamil were given to the patients in the treatment group.Patients in both groups received intravenous administration of 20 to 30 mg of doxorubicin 3 ～ 5 hours before the intraperitoneal chemotherapy,and 0.1 g of leucovorin 30 minutes prior to the intraperitoneal chemotherapy.On the second day,intraperitoneal chemotherapy of 0.5 to 0.75 g 5-fiuorouracil was given to all patients for 3 to 5 days.The disease-free survival rate,overall survival rate,disease-free survival (DFS),overall survival (OS),peritoneal recurrence rate,liver metastasis rate,gastric remnant recurrence rate,adverse reactions were examined and recorded at the time points of 12 and 24 months after the chemotherapy treatment.Results In the treatment group,disease-free survival and overall survival rates at 12 and 24 months were significantly higher than those in the control group,and the median DFS and OS were significantly longer than the control group (P ＜ 0.05).In patients with regional lymph node staging (N2,N3),low differentiated adenocarcinoma,tumor diameter greater than 4-cm,the disease free survival rate and overall survival rate at 12 and 24-months were significantly higher than the control group,and the median DFS and OS were significantly longer than the control group (P ＜0.05).In the treatment group,intraperitoneal recurrence rate and liver metastasis rate at 12 and 24-months were significantly lower than the control group (P ＜ 0.05).There was no significant difference in recurrence rate of gastric stump between the control group and treatment group.Application of verapamil did not increase the incidence rate of adverse reactions.There were 8 patients with mild abdominal pain and 3 patients with incomplete intestinal obstruction,and all of them were cured after one week of treatment.Conclusion The intraperitoneal perfusion of verapamil and chemotherapeutic drugs can significantly increase the disease-free survival rate and overall survival rate,prolong the median DFS and OS,reduce the recurrence rate of intra-abdominal and liver metastasis rate in the gastric cancer patients at 12 and 24 months after chemotherapy.
