Abstract: Objective To investigate the effect of apatinib combined with intraperitoneal hyperthermia and intravenous chemotherapy in the treatment of advanced gastric cancer with peritoneal metastasis.Methods The clinical data of 80 patients with advanced gastric cancer peritoneal metastasis admitted to the hospital from July 2017 to April 2021 were retrospectively analyzed.Among them,39 patients were given intraperitoneal hyperthermic perfusion and intravenous chemotherapy (referred to as the control group),and 41 patients were given apatinib combined with intraperitoneal hyperthermic perfusion and intravenous chemotherapy (referred to as the study group).The effect was evaluated were evaluated after 2 cycles of treatment in both groups.The patients were followed up for 1 year.The short-term efficacy,tumor markers,and drug safety of the two groups were compared,and the surgical resection,tumor regression,and survival during follow-up were compared between the two groups.Results The objective remission rate and clinical control rate in the study group were higher than those in the control group (P<0.05).After treatment,the levels of carcinoembryonic antigen (CEA) and Carbohydrate antigen 199 (CA199) in the two groups were decreased (P<0.05).The levels of CEA and CA199 were lower than control group after treatment(P<0.05).There was no significant difference in the incidence of leukopenia,neutropenia,fatigue,anemia,hand-foot syndrome and proteinuria between the two groups (P>0.05).The R0 resection rate in the study group was higher than that in the control group (P<0.05).The 1 year overall survival rate of study group was higher than control group (P<0.05).Conclusion Apatinib combined with intraperitoneal hyperthermic perfusion and intravenous chemotherapy has a significant curative effect in the treatment of advanced gastric cancer with peritoneal metastases and transformation.It can reduce the level of tumor markers,increase the R0 resection rate,improve TRG,and prolong the short-term survival rate of patients with good safety.

Key words: advanced gastric cancer, peritoneal metastasis, conversion therapy, apatinib