Intraperitoneal perfusion chemotherapy and whole abdominal hyperthermia using external radiofrequency following radical D2 resection for treatment of advanced gastric cancer

Abstract

Background: The peritoneum is the most frequent site of disease recurrence in gastric cancer, and the prognosis remains poor. This study assessed the role of adjuvant intraperitoneal (IP) chemotherapy with whole abdominal hyperthermia using external radiofrequency in gastric cancer patients after D2 dissection.

Methods: Patients with gastric cancer who underwent gastrectomy with D2 regional lymph node dissection were enrolled in the study. Patients received IP chemotherapy with whole abdominal hyperthermia. Preheated normal saline containing 75 mg/m² of cisplatin was delivered into the abdominal cavity through a Tenckhoff catheter at McBurney’s point. Regional hyperthermia was performed using two sets of orthogonal radiofrequency waves immediately after all saline was irrigated into the abdominal cavity. For each patient, recurrent or metastatic sites and adverse events were evaluated.

Results: A total of 22 patients were finally included. All patients tolerated hyperthermia well. Only two patients experienced grade 1 superficial thermal injury. The most frequent grade 3/4 adverse events were myelosuppression, nausea/vomiting, trichomadesis and liver dysfunction. We also found IP chemotherapy with whole abdominal hyperthermia could reduce the total recurrent/metastatic rate, especially peritoneal metastasis (4.5%).

Conclusions: This hypothesis-generating study indicated that IP chemotherapy with whole abdominal hyperthermia might be feasible for gastric cancer patients after D2 resection.

Keywords:

• Chemotherapeutic hyperthermic intraperitoneal perfusion
• hyperthermia
• peritoneal metastasis
• gastric cancer

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by grants from Hangzhou KEY Project of Radiation Oncology (2018), Science and Technology Project of Hangzhou Bureau (2018A33), Major Science and Technology Project of Hangzhou Bureau (2015ZD01), Social development project of Hangzhou Municipal Science and Technology Commission (20170533B95) and National Natural Science Foundation of China (81773242). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.