METHODS
The general information
A total of 56 patients from June 2014 to June 2015 with advanced gastric cancer postoperative chemotherapy were collected, and the method of random number tables was used to randomly divided 56 patients into the experimental group and the control group. There were 22 cases in the experimental group, including 10 males and 12 females, aged 40 to 79 years, and the median age was 66.4 years. In the control group, there were 23 cases, 11 males and 12 females, aged 46 to 80 years, and the median age was 64.4 years. All patients were completed gastric cancer D2 radical surgery, the cases were diagnosed with gastric cancer stage II, IIIa and IIIb by postoperative pathological histology, and assessed more than 60 points with Karnofsky Performance Status (KPS), the patients were expected to survive more than 3 months, no more than 80 years old, with normal blood picture, liver and kidney function, without vital organ lesions history of other malignancies and contraindications of chemotherapy and hyperbaric oxygen therapy. The study was approved by the Ethics Committee of Renji Hospital and informed consents were obtained from all patients. There was no statistically significant difference in general information between the two groups of patients, as shown in Table 1.
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(To view a larger version of Table 1, click here.)
The postoperative chemotherapy regimen
D2 gastric cancer radical surgery was done by the same leading physicians, and routine chemotherapy for 3–4 weeks were done after surgery. The project of capecitabine and oxaliplatin for 3-week was adopted: carpeyabine 1,000 mg/m2 was taken orally twice a day from day 1 to day 14, and oxaliplatin 130 mg/m2 was intravenously injected for 2 hours. A period consists of 3 weeks, and there are eight periods. If serious adverse reactions occurred or markers of tumor markers are increased in patients during chemotherapy, the chemotherapy regimen will be changed according to the situation. The methoxyclopamine and dexamethasone were used to prevent nausea and vomiting during chemotherapy.
High pressure oxygen solution
Hyperbaric oxygen combined with chemotherapy were performed in the experimental groups. The medical hyperbaric oxygen chamber with pure O2 was used to treatment, the pressure is 2.0–2.5 absolute atmosphere (ATA), the patient absorbed oxygen 20 min ×4, and absorbed air discontinuously 5 min ×3. Hyperbaric oxygen is absorbed five times before chemotherapy, once a day, and then the hyperbaric oxygen and chemotherapy were performed simultaneously. The chemotherapy was started at 15–30 min after the absorption of oxygen, the pure saturated oxygen was absorbed for 1 hour after chemotherapy, the hyperbaric oxygenation was continued to absorbed 10 times and once a day during the interval chemotherapy.
Observation standards and indicators
Two groups of patients were expected to complete eight chemotherapy periods, the imaging evaluation results of two groups of patients in the experimental group and the control group were compared, the upper abdominal enhancement computed tomography (CT) were used to evaluate tumor recurrence and enlarged lymph node status, the changes of tumor indicators (CEA and CA199) in two groups of chemotherapy patients were observed, the chemotherapy adverse reaction were classified into 0 (no), I (mild), II (moderate), III (severe) and IV (heavy) according to the WHO evaluation standard. Quality of Life-Core 30 Questionnaire (QLQ-C30) developed by EORTC was performed to evaluated life quality of patients. The questionnaire was completed by the patients, and the questionnaire content was presented the patients with dyslexia by the doctor or their family members who answered the questionnaire according to the patient’s answers, as the basis for the evaluation of the clinical application effect.
Statistical method
SPSS13.0 software was used to analyze data statistics. The metering information are presented as mean ± SD. Differences between means were determined by Student’s t-test with in two groups the counting data were indicated by the adoption rate (%) and the χ2 test is adopted. P<0.05 was set as a significant criterion.
RESULT
Comparison of general data before chemotherapy
The age, nutritional status, gender and pTNM stage of the two groups were not statistically significant (P>0.05) (Table 1).
Imaging indicators evaluation
Experimental group and control group 1-year image evaluation for recurrence or lymph node metastasis were 1 case (4.54%) and 6 cases (26.0%) respectively; the recurrence rate of the experimental group was significantly lower than that in the control group, and the difference between the two groups was statistically significant (χ2=3.972, P=0.046).
