Effect of neoadjuvant chemotherapy combined with arterial chemoembolization on short- term clinical outcome of locally advanced gastric cancer

Abstract

Abstract Background.The purpose of this study was to explore the short-term efficacy and safety of neoadjuvant chemotherapy combined with arterial chemoembolization for locally advanced gastric cancer (LAGC). Methods. We retrospectively analyzed the clinical data of 203 patients with LAGC who received neoadjuvant therapy from June 2019 to December 2021. The patients were divided into neoadjuvant chemotherapy combined with arterial chemoembolization group (Combined group, n=102) and neoadjuvant chemotherapy group (Conventional group, n=101). The adverse events of chemotherapy, postoperative complications and pathological complete response (pCR) rate were compared between the two groups. The potential factors of influencing pCR were evaluated by univariate analysis and multivariate analysis. The univariate and multivariate analysis were performed to evaluate the potential factors affecting pCR. Results. 78.8% of patients were in clinical stage III before neoadjuvant therapy. 52.2% patients underwent surgery after receiving two cycles of neoadjuvant therapy. There were 21.2% patients with≥ grade 3 (CTCAE 4.0) adverse events of chemotherapy and 11.3% patients with Clavien-Dindo classification ≥ grade 3 postoperative complications. Compared with the conventional group, the combination group did not increase the adverse events of chemotherapy and postoperative complications. The pCR rate in the combined group was significantly higher than that in the conventional group (16.7% vs 4.95%, P=0.012). Multivariate analysis showed that arterial chemoembolization, pre-treatment neutrophil-to-lymphocyte ratio (NLR) and pre-treatment platelet-to-lymphocyte ratio (PLR) were independent factors affecting pCR. Conclusion.Neoadjuvant chemotherapy combined with arterial chemoembolization contributed to improving the pCR rate of LAGC patients. Arterial chemoembolization, pre-treatment NLR and pre-treatment PLR were also predictors of pCR.