Paclitaxel HIPEC safe, effective in adenocarcinoma of oesophagogastric junction

Hyperthermic intraperitoneal chemotherapy (HIPEC) improves postoperative cellular immune function in patients with adenocarcinoma of the oesophagogastric junction (AEG), a recent study has found.

The study included 252 patients with advanced AEG who were randomly assigned to receive surgery alone (n=126) or postoperative paclitaxel HIPEC (n=126). Analysis of lymphocyte subsets showed that proportions of CD3⁺ (69.14±6.11 vs 66.16±6.66 percent; p=0.001) and CD3⁺CD4⁺ (40.81±7.08 vs 38.34±6.71 percent; p=0.011) T cells were significantly higher in the HIPEC vs surgery control group.

In contrast, CD3⁺CD8⁺ (22.97±5.69 vs 25.21±5.81 percent; p=0.006) and CD4⁺CD25⁺ (10.26±2.07 vs 12.79±2.10 percent; p<0.001) T cells were significantly suppressed in the HIPEC group relative to surgery alone. The same was true for CD4⁺PD-1⁺ (11.43±3.36 vs 12.60±3.46 percent; p=0.015) and CD8⁺PD-1⁺ (10.50±3.58 vs 12.46±4.22 percent; p<0.001) T cells.

“These results indicate that HIPEC following the operation can improve the cellular immune function and facilitate the release of a cellular immunosuppressive state,” the researchers said.

In terms of side effects, the researchers documented four cases of incision infection in the HIPEC group, along with three cases of anastomotic leakage. In surgery-only controls, two cases of incision infection and four cases of anastomotic leakage were reported. On control patient developed intestinal obstruction, while no such complication occurred in the HIPEC arm.

All cases of complications resolved following timely treatment. The frequency at which complications developed was comparable between arms, suggesting that paclitaxel HIPEC is a safe procedure for advanced AEG patients, the researchers pointed out.