Combined Prophylactic Hyperthermic Intraperitoneal Chemotherapy and Intraoperative Radiotherapy for Localized...

Area of Science:

• Oncology
• Surgical Oncology
• Gastrointestinal Oncology

Background:

• Peritoneal recurrence is a common issue after gastric cancer resection.
• Hyperthermic intraperitoneal chemotherapy (HIPEC) and intraoperative radiotherapy (IORT) may reduce peritoneal recurrence and improve survival.
• This study evaluates the combination of prophylactic HIPEC and IORT after radical resection for localized gastric cancer.

Purpose of the Study:

• To assess the efficacy of combining prophylactic HIPEC and IORT in patients undergoing radical resection for localized gastric cancer.
• To determine the impact of this combined treatment on locoregional recurrence, peritoneal metastasis, recurrence-free survival (RFS), and overall survival (OS).

Main Methods:

• Retrospective analysis of adult patients with gastric/gastroesophageal adenocarcinoma undergoing radical resection with curative intent.
• Comparison of outcomes between patients who received prophylactic HIPEC and IORT versus those who had surgery only.
• Evaluation of recurrence patterns and survival data based on treatment received.

Main Results:

• Out of 58 eligible patients, 33 received prophylactic HIPEC and IORT.
• Locoregional recurrence occurred in 18.1% of the HIPEC/IORT group and 20% of the surgery-only group.
• Peritoneal metastasis occurred in 9% of the HIPEC/IORT group versus 24% of the surgery-only group.
• Median recurrence-free survival was 23.2 months (HIPEC/IORT) vs. 24.8 months (surgery-only) (p=0.88).
• 5-year overall survival estimates were 69% (HIPEC/IORT) vs. 58% (surgery-only).

Conclusions:

• Prophylactic HIPEC and IORT did not significantly improve recurrence-free survival or overall survival in this unselected patient group.
• The combination therapy showed a trend towards reduced peritoneal metastasis but did not translate to improved survival outcomes.