Docetaxel plus 5-fluorouracil for terminal gastric cancer patients with peritoneal dissemination.
OBJECTIVE
There are few reports on chemotherapy for poor prognosis terminal patients with peritoneal dissemination of gastric cancer, especially in those with renal dysfunction, because of the possibility of severe toxicity. We conducted a study of the combination of docetaxel and 5-fluorouracil for the treatment of these patients to improve quality of life because of its low toxicity.


METHODS
Five patients were treated in this study. All patients had a large volume of carcinomatous fluid in the abdomen, without liver or distant metastasis. The respective doses of docetaxel and 5-fluorouracil were 60 mg/m2 on day 1 and 370 mg/m2 on days 1 to 5 by intravenous infusion. Patients received this treatment 2-7 times every 2-3 weeks.


RESULTS
Grade III/IV toxicity occurred, consisting of neutropenia (100%) and diarrhea (40%). No patients developed renal dysfunction. Carcinomatous fluid volume diminished for 15-96 days. Quality of life questionnaire score and performance status scale was significantly improved from 75-86 to 51-61 (p = 0.041) and 3-4 to 0-1 (p = 0.039), respectively. All patients were able to leave hospital after this treatment. Four of five patients died and median survival time was 223 days. Two of five patients achieved partial response and three patients showed no response (response rate 40%).


CONCLUSIONS
This new combination therapy had benefit for terminal patients with peritoneal dissemination of gastric cancer.
Third Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchikami machi, Itabashi-ku, Tokyo 173-8610, Japan. teruo@med.nihon-u.ac.jp
Teruo
T
Eguchi
Masashi
M
Fujii
Kazuhiko
K
Wakabayashi
Kazuo
K
Aisaki
Yutaka
Y
Tsuneda
Mitsugu
M
Kochi
Tadatoshi
T
Takayama
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000473:pathology*; D011379:Prognosis; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D043823:Taxoids / Q000627:therapeutic use*
D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D000077143:Docetaxel; D005472:Fluorouracil