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. 2025 Jun 5;151(6):183.
doi: 10.1007/s00432-025-06169-y.

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

Jiajia Zhang  1 , Gang Zhou  1 , Meipan Yin  1 , Yishu Ma  1 , Wei He  2 , Yonghua Bi  1 , Gang Wu  3
Affiliations

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

Jiajia Zhang et al. J Cancer Res Clin Oncol. .

Abstract

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.

Keywords: Chemoembolization; Gastric cancer; Lipiodol; Obstruction; Transcatheter infusion chemotherapy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by The First Affiliated Hospital of Zhengzhou University Ethics Review Committee (Ethics ID: 2021-KY-0910-002). This study was performed in accordance with the Declaration of Helsinki. Written informed consent was obtained from all patients enrolled in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A 69-year-old female with difficulty swallowing as the initial symptom was diagnosed with Stooler grade 3 gastric cancer. (a-c) Upper abdominal computed tomography (CT) images show thickened gastric cardia and fundus and distinct masses protruding into the gastric cavity and affecting the entire gastric wall layer (white arrows), with tumor metastases in the omentum. And she was evaluated as clinical stage IV. (d-f) CT performed one month after the interventional treatment showed partial lipiodol deposition in the lesion, markedly less than before the procedure
Fig. 2
Fig. 2
The interventional treatment process. (a) The transcatheter angiography showed thickening and tortuosity of the left gastric artery, increased branching, and apparent tumor-like staining in the gastric cardia region. (b) Lipiodol emulsion was injected slowly through a microcatheter. (c) Lipiodol deposition in the tumor area after embolization
Fig. 3
Fig. 3
Survival analysis curves for two groups. Group 1 was treated by transcatheter arterial infusion chemotherapy combined with transcatheter arterial lipiodol chemoembolization (TAI-TACE), and Group 2 by transcatheter arterial infusion chemotherapy combined with bland embolization (TAI-BE)
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