Efficacy of intraperitoneal thermochemotherapy and immunotherapy in intraperitoneal recurrence after gastrointestinal cancer resection.
OBJECTIVE
To investigate the prophylactic and therapeutic efficacy of intraperitoneal IL-2 immunotherapy following intraperitoneal thermochemotherapy in the metastasis and recurrence of gastric and colorectal cancer after operation.


METHODS
Forty-two gastric cancer patients at T(3)II-T(4)III( B) stages and 96 patients with colorectal cancer at B to D stages admitted from January 1996 to October 1998 were randomly divided into control group (group I, 65 cases) receiving intraperitoneal thermochemotherapy, and group II (73 cases) receiving both intraperitoneal thermochemotherapy and intraperitoneal IL-2 immunotherapy. Distilled water at 43-45 degrees containing 5-Fu 0.5 g/L and MMC 8 mg/L was perfused into peritoneal cavity before closure at the end of operation for 1 h, and from the third day, IL-2 10 million IU in 500 ml 0.9 % sodium chloride was intraperitoneally administrated daily for 10 times. One month after operation, all the patients underwent regular intravenous chemotherapy. Before and after the IL-2 immunotherapy, some Th1 type cytokines in the peripheral blood of the patients in the two groups were detected by ELISA, and the intraperitoneal recurrence and liver metastasis rates and the 3-year survival rate were statistically evaluated after intensive follow-up.


RESULTS
IL-2 intraperitoneal immunotherapy significantly elevated the level of some Th1 type cytokines (P<0.01 compared with that of control group), and the 3-year survival rate of group II was 18.1 % higher and the rates of intraperitoneal recurrence and liver metastasis were 16.9 % and 6.0 % lower than those of group I significantly (P<0.05-0.01).


CONCLUSIONS
The combination of intraperitoneal IL-2 immunotherapy and thermochemotherapy could promote Th1 immune paradigm and enforce anti-tumor activity of bodies, which plays a positive role in preventing gastric and colorectal cancer from intraperitoneal recurrence and development.
Fu
Qing-Guo
QG
The Second General Surgery Department of The First Clinical College, China Medical University, Shenyang 110001, Liaoning Province, China. qingguofu@hotmail.com
Meng
Fan-Dong
FD
Shen
Xiao-Dong
XD
Guo
Ren-Xuan
RX
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D015179:Colorectal Neoplasms / Q000276:immunology / Q000628:therapy*; D003131:Combined Modality Therapy; D016207:Cytokines / Q000276:immunology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D006979:Hyperthermia, Induced; D007167:Immunotherapy; D007263:Infusions, Parenteral; D007376:Interleukin-2 / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local / Q000276:immunology / Q000628:therapy; D010534:Peritoneal Neoplasms / Q000276:immunology / Q000556:secondary / Q000628:therapy*; D013274:Stomach Neoplasms / Q000276:immunology / Q000628:therapy*; D018417:Th1 Cells / Q000276:immunology
D016207:Cytokines; D007376:Interleukin-2; D016685:Mitomycin; D005472:Fluorouracil