[Experimental and clinical study on intraoperative local infusion chemotherapy (ILIC) for advanced gastric carcinoma]

An intensive chemotherapy combined with surgery, termed "intraoperative local infusion chemotherapy (ILIC)", was devised. The ILIC procedure is to infuse 50 mg of cisplatin through the feeding artery to the tumor, which has been isolated from blood flow by clamping the stomach and blood vessels, before radical surgery. An experiment in dogs showed considerable free Pt transfer into thoracic lymph after ILIC. Sum total Pt in the thoracic lymph after ILIC (294.5 micrograms/3 h) was 4.3 times that after IV administration (68.3 micrograms/3 h). In ILIC, AUC of free Pt in the thoracic lymph was about 5.8 times that in peripheral blood. ILIC was applied in 24 advanced gastric cancer patients, consisting of 6, 2, 4 and 12 in pTNM stage II, IIIA, IIIB and IV, respectively. Pt concentration of the tissues was high in the tumor (23.22 micrograms/g) and the regional lymph nodes (2.95 micrograms/g) compared to that in the serum (0.45 microgram/ml). The survival rate (Kaplan-Meier) in the ILIC patients was significantly higher than that of control patients (matched pair method) from among patients treated by surgery alone. No fatal complications were encountered in any patient treated by ILIC.