Transcatheter arterial infusion chemotherapy combined with lipiodol chemoembolization for advanced gastric fundus and cardia cancer with obstruction.

Purpose: Gastric fundus and cardia cancer are increasingly common, diagnosed at a late stage, often with severe obstruction, and have a poor prognosis. Transcatheter arterial lipiodol chemoembolization (TACE) is rarely used for gastric cancer. This single-center retrospective study aimed to analyze the efficacy and safety of transcatheter arterial infusion chemotherapy (TAI) combined with TACE in advanced gastric fundus and cardia cancer with obstruction and compare it to bland embolization (BE).

Materials and methods: The clinical efficacy of TAI-TACE was evaluated through technical and clinical success rates, obstruction relief, tumor response, overall survival (OS), and postoperative adverse events. TAI-TACE and TAI-BE efficacies were compared.

Results: The study included 53 patients (age 70.0 ± 11.1 years, 38 males). Thirty-two patients underwent TAI-TACE, and 21 underwent TAI-BE. The cohort's technical success rate was 100%. The pre- and post-intervention median Stooler grades were 4 and 2 in the TAI-TACE group and 3 and 3 in the TAI-BE group, respectively. Compared to the TAI-BE group, the TAI-TACE group had a higher clinical success rate (78.1%, 25/32 vs. 42.9%, 9/21; P = 0.009), a better objective response rate (53.1% vs. 38.1%; P = 0.016), and a longer median OS (13.0; 95% confidence interval (CI), 3.2-22.8 vs. 10.0; 95% CI, 8.5-11.5; P = 0.039) months. All adverse events were grade 1.

Conclusion: The TAI-TACE interventional therapy scheme was safe and effective, achieving rapid tumor shrinkage, obstructive symptom alleviation, improved quality of life, and a significantly better overall effect than TAI-BE.