Effects of CHOP as Preoperative Regional Intra-Arterial Infusion Chemotherapy in Primary Gastric Malignant Lymphoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Xiaoyu , YAO Xuequan ,  CHEN Che , CHEN Zhiwei , CAO Qinhong , ZHAI Jing , LIU Fukun.

Department of Digestive Tumor Surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing 210029, Jiangsu Province, China;

Corresponding author：

CHEN Che, Email: drchenche@sohu.com

Keywords：

Primary gastric malignant lymphoma; Neoadjuvant chemotherapy; Arterial infusion

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ObjectiveTo evaluate the effects of CTX, EADM, VCR, and Pred (CHOP) as preoperative regional intra-arterial infusion chemotherapy in primary gastric malignant lymphoma (PGML). MethodsForty-one patients with PGML underwent preoperative regionalarterial infusion chemotherapy. The regimen consisting of CTX 600 mg/m2, EADM 50 mg/m2, VCR 1.4 mg/m2, and Pred 60 mg/m2, was administrated 14－21 d before operation. Another 33 patients with similar PGML during the same period underwent surgery directly. The response of the tumor and chemotherapy toxicity were observed, together with the survival of the cases. ResultsAmong the 33 patients undergoing surgery directly, 24 cases (72.7%) had curative resection, the 5-year survival rate was 58.3% (14/24). All 41 patients of the neoadjuvant chemotherapy group completed the planned regimen of chemotherapy and surgery successfully. The most common related adverse effects were grade Ⅰ-Ⅱ gastrointestinal discomfort (22 cases) and bone marrow suppression (14 cases). Thirtyseven cases (90.2%) underwent curative resection, the 5year survival rate was 67.7% (21/31). There was no significant difference between two groups in 5year survival rate (χ2=0.517， P＝0.471), while with significant difference in curative resection rate (P＝0.041). ConclusionsNeoadjuvant intra-arterial infusion chemotherapy (CHOP) has been wellrated; it appears to have improved the resectable rate of the PGML patients studied.

Citation： WU Xiaoyu,YAO Xuequan,CHEN Che,CHEN Zhiwei,CAO Qinhong,ZHAI Jing,LIU Fukun.. Effects of CHOP as Preoperative Regional Intra-Arterial Infusion Chemotherapy in Primary Gastric Malignant Lymphoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(12): 1296-1300. doi: Copy

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1. 胡建昆, 陈志新, 陈佳平, 等. 原发性胃恶性淋巴瘤的诊断和外科治疗 [J]. 中国普外基础与临床杂志, 1999, 6(3): 160161.
2. Doglioni C, Ponzoni M, Ferreri AJ, et al. Gastric lymphoma: the histology report [J]. Dig Liver Dis, 2011, 43 Suppl 4: S310S318.
3. Dawson IM, Cornes JS, Morson BC. Primary malignant lymphoid tumours of the intestinal tract. Report of 37 cases with a study of factors influencing prognosis [J]. Br J Surg, 1961, 49: 8089.
4. 孙燕, 石远凯. 临床肿瘤内科手册 [M]. 北京: 人民卫生出版社, 2007: 142.
5. Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada [J]. J Natl Cancer Inst, 2000, 92(3): 205216.
6. 马建辉. 重视实体瘤疗效评价标准的变革RECIST概要 [J]. 中华泌尿外科杂志, 2006, 27(2): 7779.
7. Suzuki C, Jacobsson H, Hatschek T, et al. Radiologic measurements of tumor response to treatment: practical approaches and limitations [J]. Radiographics, 2008， 28(2): 329344.
8. 日本胃癌學會編. 胃癌取扱い規約 [M]. 第14 版. 東京: 金原出版, 2010: 155.
9. 严庆汉. 恶性淋巴瘤的临床分期//肿瘤病理诊断学 [M]. 第2 版. 天津: 天津科学技术出版社, 1999: 345347.
10. Ghimire P, Wu GY, Zhu L. Primary gastrointestinal lymphoma [J]. World J Gastroenterol, 2011, 17(6): 697707.
11. Ferrucci PF, Zucca E. Primary gastric lymphoma pathogenesis and treatment: what has changed over the past 10 years? [J]. Br J Haematol, 2007, 136(4): 521538.
12. 张超, 姜军, 阮圣兴. 胃原发性恶性淋巴瘤的诊断与治疗 [J]. 中国普外基础与临床杂志, 2002, 9(4): 269271.
13. Raderer M, Paul de Boer J. Role of chemotherapy in gastric MALT lymphoma, diffuse large Bcell lymphoma and other lymphomas [J]. Best Pract Res Clin Gastroenterol, 2010, 24(1): 1926.
14. 蔡兆辉, 于东风, 刘弋. 原发性胃淋巴瘤的临床诊断和外科治疗 [J]. 安徽医科大学学报, 2007, 42(5): 588590.
15. Parvez T, Behani A, Ali A. Primary gastric lymphoma [J]. J Coll Physicians Surg Pak, 2007, 17(1): 3640.
16. Wilke H, Preusser P, Fink U, et al. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase Ⅱ study with etoposide, doxorubicin, and cisplatin [J]. J Clin Oncol, 1989, 7(9): 13181326.
17. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer [J]. N Engl J Med, 2006, 355(1): 1120.
18. Barone C, Cassano A, Pozzo C, et al. Longterm followup of a pilot phase Ⅱ study with neoadjuvant epidoxorubicin, etoposide and cisplatin in gastric cancer [J]. Oncology, 2004, 67(1): 4853.
19. Kochi M, Fujii M, Kanamori N, et al. Neoadjuvant chemotherapy with S1 and CDDP in advanced gastric cancer [J]. J Cancer Res Clin Oncol, 2006, 132(12): 781785.
20. Mezhir JJ, Tang LH, Coit DG. Neoadjuvant therapy of locally advanced gastric cancer [J]. J Surg Oncol, 2010, 101(4): 305314.
21. 刘福坤, 李国立, 陈忠豪, 等. 胃癌术前介入治疗的临床和病理观察(附250例报告) [J]. 南京大学学报(自然科学版), 1998, 34(2): 167171.
22. 刘福坤, 陈忠豪, 李国立, 等. 胃癌术前介入治疗后血管变化与癌组织坏死的关系 [J]. 华人消化杂志, 1998, 6(8): 686688.
23. Li M, Zhang J, Wang D, et al. A phase Ⅱ study of intraarterial chemotherapy of 5fluorouracil, cisplatin, and mitomycin C for advanced nonresectable gastric cancer [J]. Anticancer Drugs, 2009, 20(10): 941945.
24. 刘福坤, 姚学权. 胃癌的新辅助化疗 [J]. 中国普外基础与临床杂志, 2006, 13(1): 1720.
25. Zhang CW, Zou SC, Shi D, et al. Clinical significance of preoperative regional intraarterial infusion chemotherapy for advanced gastric cancer [J]. World J Gastroenterol, 2004, 10(20): 30703072.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effects of CHOP as Preoperative Regional Intra-Arterial Infusion Chemotherapy in Primary Gastric Malignant Lymphoma

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