The Efficacy and Tolerance of High Pressure Oxygen Combined With Chemotherapy in Postoperative Patients With Advanced Gastric Cancer

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Gastric cancer is among the most frequently diagnosed cancers in the world, and its incidence is increasing. The standard of care for patients with gastric cancer is surgery followed by postoperative adjuvant chemotherapy, but outcomes remain unsatisfactory; there is need to improve the efficacy of chemotherapy.

Hypoxia is a common characteristic of solid tumors and may lead to tumor growth, metastasis, and drug resistance. Evidence has shown that hyperbaric oxygen during chemotherapy may improve tumor cell sensitivity to treatment, increase intratumoral concentrations of treatment drugs, and reduce the incidence and severity of certain adverse reactions.

For this study, researchers evaluated the effects of hyperbaric oxygen plus postoperative chemotherapy vs conventional chemotherapy alone in patients with advanced gastric cancer. Tumor imaging, tumor index, adverse reactions, and quality of life were compared between the experimental and control groups.

Translational Cancer Research
Translational Cancer Research

Background: The aim of this study was to investigate the clinical efficacy analysis and tolerance observation of hyperbaric oxygen combined with chemotherapy in postoperative patients with advanced gastric cancer.

Methods: A total of 56 patients from June 2014 to June 2015 with advanced gastric cancer postoperative chemotherapy were collected. These patients were randomly divided into the experimental group of 22 patients treated with hyperbaric oxygen combined with chemotherapy, and the control group of 23 patients treated with conventional chemotherapy. The results of imaging evaluation, tumor index, adverse reaction of chemotherapy and quality of life (QOL) were compared between the two groups.

Results: The recurrence rate of 1 year imaging was 4.54% and 26.0% respectively in the experimental group and the control group, and the two groups had statistical differences (P=0.046); The persistent abnormal index of CA199, showed in the experimental group and the control group, accounting for 13.6% and 43.4% severally, which showed statistical differences (P=0.027); Compared with the control group, the incidence of hemocytopenia, thrombocytopenia, nausea and vomiting and peripheral nervous reaction were reduced in the experimental group, and there was a statistically significant difference between the two groups (P<0.05); The Quality of Life-Core 30 Questionnaire (QLQ-C30) score of the experimental group was 42.32±16.20, the control group was 79.53±18.54, and the life quality score of the experimental group was significantly lower than that of the control group (P<0.0001). There was no statistical difference between the two groups in hemoglobin and diarrhea (P>0.05).

Conclusions: Hyperbaric oxygen combined with chemotherapy applied to postoperative chemotherapy for gastric cancer achieved good clinical effect, which reduced the recent local recurrence rate and the toxic side reaction, significantly improved the safety and tolerance of chemotherapy in patients.


Keywords: Postoperative gastric cancer; hyperbaric oxygen; chemotherapy

Submitted Dec 20, 2017. Accepted for publication Apr 03, 2018.

doi: 10.21037/tcr.2018.04.16 


INTRODUCTION

The incidence of gastric cancer is increasing year by year, clinical patients are mostly diagnosed with advanced gastric cancer. The effect of surgical treatment is often limited, it is necessary to be further treated with chemotherapy, but the overall effect is still unsatisfactory. How to improve the sensitivity of cancer cells on chemotherapy drugs and simultaneously reduce the damage of chemotherapy drugs on normal tissue cells has become an important research topic. Much progress of hyperbaric oxygen on malignant tumor treatment has been made, and the sensitization mechanism that hyperbaric oxygen treats malignant tumors has been proved in the experiment, which has a good prospect in the adjuvant therapy of malignant tumor; however, the clinical application in gastric cancer after operation has not been reported. In this paper, we combined gastric cancer postoperative with hyperbaric oxygen therapy to explore the clinical application in postoperative chemotherapy for advanced gastric cancer. 

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