Clinical Efficacy of Intravenous Chemotherapy Alone Versus Intravenous Combined with Intraperitoneal Chemotherapy for Newly Diagnosed Gastric Cancer with Malignant Ascites

Background: To retrospectively evaluate clinical efficacy and adverse reactions of intravenous chemotherapy along vs. intravenous combined with intraperitoneal chemotherapy (IPC) in newly diagnosed gastric cancer (GC) with malignant ascites. Methods: Between September 2010 and September 2015, a total of 33 newly diagnosed GC patients combined with malignant ascites were evaluated, of whom 18 received intravenous chemotherapy alone (the simple group) and 15 received intravenous combined with intraperitoneal chemotherapy (the combination group). The short-term objective efficacy and adverse reactions of all patients were evaluated based on treatment methods and the results of follow-up examinations. Simultaneously, the median survival period and the 12-, 18-, 24-, 30-, 36-, 60-month survival rates were obtained through follow-up with patients to evaluate the long-term efficacy. Results: The patient baseline characteristics were similar in two groups in regard to age, gender, ECOG scores before treatment, number of metastatic sites, pathological grading, clinical stage and therapy history (P>0.05). As to the objective efficacy, the objective response rate (ORR) and disease control rates (DCR) were significantly lower in the simple group compared with those in the combination group (11.11% vs. 40.00%, P>0.05; 44.44% vs. 80.00%, P<0.05). The local ORR and DCR of malignant ascites from advanced GC patient in the simple group after treatment were 22.22% and 55.56%, respectively, which were also significantly lower than the 66.67% and 100% results of advanced GC patients in the combination group (all P<0.05). The median survival time (MST) of the simple group was 6.03 +/- 1.59 months, which was significantly shorter than 17.03 +/- 2.62 months in the combination group (P<0.05). In addition, the 12-, 18-, 24-, 30-, 36-, and 60-month survival rates of the simple group were all significantly lower than those of combination group correspondingly. Comparison of advanced GC patients in these two groups revealed that all the differences were also statistically significant (all P<0.05). Furthermore, the effect on the improvement in the physical conditions of GC patients in simple group after treatment was minimal (P>0.05), while the effect on the improvement in the physical conditions of GC patients in simple group after treatment was significantly (P<0.05). The incidence of adverse reactions in the simple group was slightly lower than that in the combination group; however, the difference between these two groups was not statistically significant (P>0.05). Neither of the groups had severe complication. Conclusions: Intravenous combined with intraperitoneal chemotherapy significantly improved the quality of life (QOL) and prolonged survival time compared with intravenous chemotherapy alone in the treatment for newly diagnosed GC patients with malignant ascites.