Comparison of Safety and Efficacy of Different Models of Target Vessel Regional Chemotherapy for Gastric Cancer with Liver Metastases

<b><i>Background/Aims:</i></b> We previously demonstrated the safety and efficacy of low-dose, short-interval target vessel regional chemotherapy (TVRC^LDSI) delivered through the hepatic artery with transarterial embolization (TAE) in patients with advanced gastric cancer (AGC). The present study aimed to compare the efficacy of TAE + TVRC^LDSI with that of standard TAE + TVRC in AGC patients with liver metastases who failed to respond to first- or second-line systemic chemotherapy. <b><i>Methods:</i></b> This study recruited a total of 58 GC patients with liver metastases after failure of first- or second-line systemic chemotherapy. Twenty-eight patients were assigned to the TAE + TVRC^LDSI group and 30 patients to the TAE + TVRC group. The primary end point was overall survival (OS^TVRC), which was defined as the time from the initiation of TVRC until the last follow-up or death. <b><i>Results:</i></b> OS^TVRC, time to progression (TTP) until appearance of intra- and extrahepatic metastases, and overall TTP and treatment periods in the TAE + TVRC^LDSI group were all significantly longer than in the TAE + TVRC group (all p < 0.001). <b><i>Conclusion:</i></b> TAE + TVRC^LDSI had a higher efficacy and safety, which was reflected by OS rates, progression-free survival rates, longer duration of treatment and milder side effects compared to standard TAE + TVRC.