Objective:To discuss the clinical effects of preoperative arterial infusion chemotherapy with oxaliplatin (OXA) and 5-fluorouracil (5-FU) in patients with advanced gastric cancer.
Methods :Forty-eight patients of advanced gastric cancer (Phase II plus) received regional intra-arterial infusion chemotherapy before operation (Group A). The regimen consisted of  one dose of OXA130mg/m and 5-FU750mg/m, administrated through the femoral artery catheterization, and  operation 8 to 12 days later. During the same period, other 48 cases of gastric cancer in the same clinical stage (Group B) were given surgery directly. All 96 patients were treated with postoperative chemotherapy intravenously by use of OXA/leucovorin/5-FU for six cycles.
Results:In group A, 38 patients (79.2%) received radical resection (R0 resection). Microscopically, 32 cases (66.7％) showed varied histopathological changes, which included tumor necrosis, lymphocyte infiltration, residual cancer cells apoptosis, interstitial edema, and fibrosis. In group B, 30 patients (62.5%) unclerwent R0 resection，which was lower than that of group A (P<0.05), but no similar pathological changes of group A were observed.The toxicities of preoperative arterial infusion chemotherapy were well tolerated and restricted to GradeⅠ～Ⅱ. There was no difference in postoperative complications between the two groups. The median survival period of group A was 36.0 months, and the 1, 2 and 3-year overall survival rate was 79.2%, 62.5% and 52.1%, respectively. In group B, the median survival time was 21.5 months, and the 1, 2, 3-year overall survival rate was 66.7%, 45.8% (P<0.05) and 35.4% (P<0.05), respectively.
Conclusions:Preoperative arterial infusion chemotherapy with OXA and 5-FU can cause significant histopathological changes that can improve the R0 resection rate and improve the 2-3 year overall survival of advanced gastric cancer.