Effects of cytoreductive surgery combined with hyperthermic perfusion chemotherapy on prognosis of patients with advanced gallbladder cancer

BACKGROUND Gallbladder cancer(GC)is a common malignant tumor and one of the leading causes of cancer-related death worldwide.It is typically highly invasive,difficult to detect in the early stages,and has poor treatment outcomes,resulting in high mortality rates.The available treatment options for GC are relatively limited.One emerging treatment modality is hyperthermic intraperitoneal chemotherapy(HIPEC).HIPEC involves delivering heated chemotherapy directly into the abdominal cavity.It combines the strategies of surgical tumor resection and localized chemotherapy administration under hyperthermic conditions,aiming to enhance the concentration and effectiveness of drugs within the local tumor site while minimizing systemic toxicity.AIM To determine the effects of cytoreductive surgery(CRS)combined with HIPEC on the short-term prognosis of patients with advanced GC.METHODS Data from 80 patients treated at the Punan Branch of Renji Hospital,Shanghai Jiao Tong University School of Medicine between January 2018 and January 2020 were retrospectively analyzed.The control group comprised 44 patients treated with CRS,and the research group comprised 36 patients treated with CRS combined RESULTS The baseline data of the research and control groups were similar(P>0.05).Six days after surgery,the alanine aminotransferase,aspartate aminotransferase,total bilirubin,and direct bilirubin levels significantly decreased compared to the preoperative levels in both groups(P<0.05).However,the values did not differ between the two groups six days postoperatively(P>0.05).Similarly,the postoperative creatinine and blood urea nitrogen levels were significantly lower than the preoperative levels in both groups(P<0.05),but they did not differ between the groups six days postoperatively(P>0.05).Furthermore,the research group had fewer postoperative adverse reactions than the control group(P=0.027).Finally,a multivariate Cox analysis identified the tumor stage,distant metastasis,and the treatment plan as independent factors affecting prognosis(P<0.05).The three-year survival rate in the study group was higher than that in the control group(P=0.002).CONCLUSION CRS combined with HIPEC lowers the incidence of adverse reactions and improves survival in patients with advanced GC.

Efficacy of continuous arterial perfusion chemotherapy combined with transarterial chemoembolization regional arterial thermal perfusion in the treatment of pancreatic cancer with liver metastases

Background:The aim of the study was to investigate the efficacy of continuous transcatheter arterial infusion chemotherapy combined with transarterial chemoembolization(TACE)for the treatment of advanced pancreatic cancer with liver metastasis.Methods:Sixty patients with advanced pancreatic cancer and liver metastases were enrolled in this study.In the treatment group,31patients underwent continuous transcatheter arterial infusion chemotherapy combined with TACE regional arterial thermal perfusion,whereas 29 patients included in the control group received intravenous chemotherapy with gemcitabine and S-1.All patients received maintenance chemotherapy with S-1 after 4 cycles of the study regimen.Treatment efficacy,quality of life,survival,and toxicity were evaluated.Results:Efficacy was better in the treatment group than in the control group,as reflected by the objective remission,partial remission,and disease progression rates(all P<0.05).The Eastern Cooperative Oncology Group and Numerical Rating Scale pain scores were also higher in the treatment group(both P<0.05).In survival analysis,the 1-year overall survival rates in the treatment and control groups were64.516%and 10.345%,respectively,whereas the median overall survival times were 16 and 6 months,respectively(both P<0.05).The6-month progression-free survival rates in the treatment and control groups were 77.419%and 13.790%,respectively,and the median progression-free survival times were 12 and 3 months,respectively(both P<0.05).The rates of hematological and nonhematological toxicological adverse effects were also lower in the treatment group(both P<0.05).Although the rate of liver dysfunction was higher in the treatment group,this finding had no adverse effects on prognosis.Conclusions:Continuous transcatheter arterial infusion chemotherapy combined with TACE regional arterial perfusion chemotherapy resulted in better efficacy and safety outcomes in patients with pancreatic cancer and liver metastasis,suggesting its utility as a reference method for the clinical treatment of advanced pancreatic cancer.

COMBINATION OF CHOLECYSTOJEJUNOSTOMY OR CHOLEDOCHJEJUNOSTOMY PERFUSION CHEMOTHERAPY AND RADIOTHERAPY FOR CANCER OF THE PANCRE

patients with unresectable cancer of the pancreatic head were admitted in our hospital form 1989 to 1995. 21 cases were treated by radiotherapy (Group A). 23 cases were treated by cholecystojejunostomy or choledojejunostomy (Group B). 20 cases were treated by cholecystojejunostomy or cholecystojejunostomy combined with superior panreatocoduodenal artery ADM,5-Fu perfusion with multifunctional implantable drugdelivery system and radiotherapy (Group C). The l-year survival rates of these three groups were 0%, 0% and 4% respectively. The authors believe that combined treatment of Group C is recommended for unresectable cancer of the pancreatic head.

INTERNAL DRAINAGE COMBINED WITH INTRAOPERATIVE RADIOTHERAPY AND CHEMOTHERAPY FORPANCREATIC HEAD CARCINOMA

Abstract: To improve the palliative effect on intermediate or advanced pancreatic head carcinoma. Methods: Operations were performed in 26 patients with intermediated or advanced pancreatic head carcinoma. Cholecystojejunostomy or choledochojejunostomy combined with intraoperative radiotherapy with an electron beam on carcinoma were performed from May, 1996 to May, 1998. Meanwhile the catheter of multifunctional implantable drug delivery system was inserted via gastroduodenal artery for postoperative perfusion chemotherapy. Result: The 3–27 month follow-up survey suggested that the tumors shrank in different degrees after the course of treatment. All patients were relieved of pain. The 6-month, 12-month and 24-month survival rates were 100%, 93.9% and 20% respectively. The average survival time of the 5 dead patients was 17.8 months. Conclusion: This operation is very effect to prolong the life of the patients with intermediate or advanced pancreatic head carcinoma.