A three-year survivor case of gastric cancer with peritoneal dissemination--an outpatient with second-line weekly paclitaxel.
This case report describes a three-year survivor case by weekly paclitaxel, who had peritoneal dissemination of gastric cancer resistant to methotrexate and 5-fluorouracil therapy. A 62-year-old female with massive ascites, abdominal pain, and difficulty in eating received a weekly paclitaxel schedule which consisted of a 1-hour infusion of paclitaxel (70 mg/m(2)) given once a week for three weeks followed by a 1-week rest, repeated every four weeks. Short course premedication was given 30 minutes prior to paclitaxel. The administrations could be performed on an outpatient basis with transient grade 3 neutropenia requiring no specific medication. Neither hypersensitivity reactions nor peripheral neuropathy developed. A dramatic disappearance of ascites and relief of abdominal pain, as well as a rapid recovery of food intake enabled the patient to be withdrawn from nutritional support through central venous catheter, indicating this schedule's contribution to improve her quality of life. A three-year survival from the commencement of weekly paclitaxel without evidence of relapse was confirmed. Weekly paclitaxel was based on the dose-dense concept, where cumulative paclitaxel exposures by frequent, repetitive administration have a more potent antitumor effect than higher dose 21-day schedule. Encouraging aspects in the weekly paclitaxel schedule in this report are that the survival time is considered to be satisfactorily long as compared with those of other case reports in the literature achieved by a convenient outpatient use with acceptable toxicities, leading to a comprehensive contribution to improve patient quality of life.
Shimoyama
Shouji
S
Gastrointestinal Unit, Settlement Clinic, Adachi-ku, Tokyo, Japan.
Kaminishi
Michio
M
D000972:Antineoplastic Agents, Phytogenic; D005260:Female; D006801:Humans; D008875:Middle Aged; D010045:Outpatients; D017239:Paclitaxel / Q000627:therapeutic use*; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel