Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jul 15, 2023; 15(7): 1283-1294
Published online Jul 15, 2023. doi: 10.4251/wjgo.v15.i7.1283
Efficacy of continuous gastric artery infusion chemotherapy in relieving digestive obstruction in advanced gastric cancer
Rui Tang, Guo-Feng Chen, Kai Jin, Guang-Qiang Zhang, Jian-Jun Wu, Shu-Gao Han, Bin Li, Ming Chao
Rui Tang, Kai Jin, Guang-Qiang Zhang, Jian-Jun Wu, Shu-Gao Han, Bin Li, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Guo-Feng Chen, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Author contributions: Tang R reviewed the literature and contributed to article drafting and statistical analysis; Li B was responsible for data acquisition and revision of the manuscript; Chao M was in charge of this project and responsible for the final revision of the manuscript; Chen GF was a surgeon from Department of Gastrointestinal Surgery, and was responsible for the evaluation of surgical indications of all patients; Jin K, and Zhang GQ were interventional physicians from the Department of Radiology, and participated in the diagnosis and treatment of patients; Wu JJ, and Han SG were experienced radiologists responsible for assessment of radiology response; all authors gave final approval for the version to be submitted.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of The Second Affiliated Hospital of Zhejiang University School of Medicine (Approval No. I2020001737).
Informed consent statement: All study participants or their legal guardian gave signed informed consent.
Conflict-of-interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Data sharing statement: Dataset available from the corresponding author at chaoming@zju.edu.cn. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming Chao, MD, Professor, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310000, Zhejiang Province, China. chaoming@zju.edu.cn
Received: March 27, 2023
Peer-review started: March 27, 2023
First decision: May 4, 2023
Revised: May 17, 2023
Accepted: June 8, 2023
Article in press: June 8, 2023
Published online: July 15, 2023
Processing time: 107 Days and 3.3 Hours
ARTICLE HIGHLIGHTS
Research background

Patients with digestive obstruction generally have advanced gastric cancer, affecting their quality of life and survival.

Research motivation

Existing methods cannot relieve digestive obstruction very well.

Research objectives

Continuous gastric artery infusion chemotherapy (cGAIC) was effective and safe in relieving digestive obstruction.

Research methods

Twenty-nine patients with digestive obstruction of advanced gastric cancer treated by cGAIC were reviewed retrospectively. Interventional treatments combined with C-arm computed tomographic angiography were performed to accurately infuse oxaliplatin into the tumor-feeding artery. Radiology responses, Stooler’s Dysphagia Score and toxic effects were evaluated.

Research results

The overall response rate was 89.7% after cGAIC. The postoperative Stooler’s Dysphagia Score was significantly reduced. Twenty-two (75.9%) of the 29 patients experienced relief of digestive obstruction after the first two cycles, and 13 (44.8%) initially unresectable patients were then considered radically resectable. The median overall survival time was 16 mo.

Research conclusions

The efficacy and safety of cGAIC in relieving digestive obstruction were demonstrated, and cGAIC could improve radical resection after cGAIC and survival time. Intraoperative CACTA can help with precise definition of the perfusion area.

Research perspectives

To improve the efficacy of chemotherapy using interventional methods.