Safety and Efficacy of Triple-Drug Hyperthermic Intraperitoneal Chemotherapy Based on Lobaplatin in the Treatment of Patients with Peritoneal Metastasis from Appendiceal and Colorectal Cancer
[Objective]To analyze the short-term safety and long-term efficacy of three-drug(Lobaplatin,Oxaliplatin and Raltitrexed)based hyperthermic intraperitoneal chemotherapy(HIPEC)in treatment of patients with peritoneal metastasis(PM)from appendiceal/olorectal cancer.[Methods]Clinicopathologic data of patients with PM of appen-diceal/colorectal cancer treated with cytoreductive surgery(CRS)+HIPEC in Cancer Hospital of Chinese Academy of Medical Sciences and Anyang Cancer Hospital from June 2017 to June 2022 were retrospectively analyzed.A total of 150 patients were divided into double-drug HIPEC group(n=78)and triple-drug HIPEC group(n=72)based on different HIPEC chemotherapy regimens.The clinicopathological features,surgical results,chemotherapy-related toxicity in-dexes and prognosis of patients were collected and analyzed.[Results]There was no significant difference in clinico-pathological data between triple-drug HIPEC group and double-drug HIPEC group(P＞0.05).The incidence of grade 3～5 severe complications in triple-drug HIPEC group was not significantly different with that of the double-drug HIPEC group(27.8％vs 30.8％,P=0.688).The mean platelet count[(225.3±53.1)×109/L vs(289.2±72.3)×109/L,P=0.029]on the fifth day after surgery in the triple-drug HIPEC group was lower than that in the double-drug HIPEC group.The proportion of patients with abnormal platelet on day 3 after surgery(13.9％vs 3.8％,P=0.029)and abnormal alanine aminotransferase on day 5 after surgery(20.8％vs 7.7％,P=0.020)in triple-drug HIPEC group was higher than that in double-drug HIPEC group.There was no significant difference in 3-year overall survival(48.5％vs 35.2％,P=0.298)and disease-free survival(35.0％vs 21.1％,P=0.470)between two groups.Multivariate Cox prognostic regression analy-sis showed that high peritoneal carcinomatosis index(HR=1.09,95％CI:1.03～1.14,P=0.005),completeness of cy-toreduction score 2～3(HR=1.93,95％CI:1.04～3.62,P=0.043)and grade 3～5 postoperative complications(HR=2.50,95％CI:1.38～4.51,P=0.004)were independent risk factors for poor overall survival;while high peritoneal carcino-matosis index(HR=1.11,95％CI:1.03～1.16,P＜0.001)and completeness of cytoreduction score 2～3(HR=3.64,95％CI:1.22～5.36,P＜0.001)were independent risk factors for poor disease-free survival.[Conclusion]The lobaplatin-based triple-drug HIPEC regimen is safe and effective for the treatment of peritoneal metastasis from appendiceal/col-orectal cancer,with a tendency of prognosis improvement.
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