Effect of EGFR inhibitor combined with neoadjuvant chemotherapy on the resection rate and prognosis of gastric cancer patients with liver metastasis after radical surgery
Objective To assess the effect of epidermal growth factor receptor(EGFR)tyrosine kinase inhibitor(TKI)combined with neoadjuvant chemotherapy on the resection rate and prognosis in gastric cancer patients with liver metastasis after radical surgery.Methods One hundred and twenty patients with gastric cancer with liver metastasis who were admit-ted to Shangqiu First People's Hospital between January 2020 and April 2022 were included,and divided into a control group(50 cases)and an observation group(70 cases)in accordance with treatment indications after obtaining patient in-formed consent,receiving the conventional neoadjuvant chemotherapy,and EGFR TKI combined with neoadjuvant chemo-therapy,respectively.The cancer resection rate,pre-and post-treatment levels of serum cytokines,and lesion relief,as well as long-term survival during a 12-month follow-up period were compared between the groups.Results After treat-ment,the observation group had higher R0 resection rate[82.86％(58/70)vs 60.00％(30/50)],and lower R1 resec-tion rate[11.43％(8/70)vs 24.00％(12/50)]and R2 resection rate[5.71％(4/70)vs 16.00％(8/50)](P＜0.05).There were no statistically significant differences in pre-treatment levels of serum cytokines between the groups(P＞0.05).After treatment,the observation group had lower levels of insulin-like growth factor-1(IGF-1)[(252.33±50.41)μg/L vs(277.36±50.32)μ g/L]and IGF-2[(45.22±5.71)μ G/L vs(48.92±5.33)μg/L],and higher level of insulin-like growth factor binding protein-3(IGFBP-3)[(1.42±0.39)μg/L vs(0.92±0.11)μg/L]than the control group(P＜0.05).Compared with the control group,the observation group had higher complete response(CR)to treatment[28.57％(20/70)vs 10.00％(5/50)],partial response(PR)to treatment[35.71％(25/70)vs 22.00％(11/50)],but lower tumor growth rate(TGR)[(35.25±8.41)％vs(41.35±10.62)％]and hyperprogressive disease(HPD)rate[7.14％(5/70)vs 24.00％(12/50)](P＜0.05).During the follow-up period,the observation group demonstrated longer median progression-free survival(PFS)[(8.41±2.33)months vs(6.45±2.71)months]and median overall survival(OS)[(10.85±3.44)months vs(8.11±1.12)months](P＜0.05).Conclusion The combination of EGFR inhibitors and neo-adjuvant chemotherapy can increase the tumor resection rate,facilitate the improvement of serum cytokines and lesion recovery,and the prolongation of survival in patient with gastric cancer with liver metastasis.
Gastric cancer with liver metastasisEpidermal growth factor receptor tyrosine kinase inhibitorNeoadjuvant chemotherapyTumor resection ratePrognostic situation
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