title: Weekly intravenous and intraperitoneal paclitaxel combined with S-1 for malignant ascites due to advanced gastric cancer.
abstract: Malignant ascites caused by gastric cancer are chemotherapy resistant and carry a poor prognosis. The efficacy of a regimen including intraperitoneal paclitaxel (PTX) was evaluated in 33 gastric cancer patients with ascetic fluid in the peritoneal cavity diagnosed with computed tomography (CT) scanning. Synchronous administration of intravenous (50 mg/m(2)) and intraperitoneal (20 mg/m(2)) PTX was performed via a subcutaneously placed intraperitoneal catheter on days 1 and 8, and S-1 was administered twice daily at 80 mg/m(2)/day for 14 consecutive days from day 1 to day 14, followed by 7 days of rest. The ascitic fluid volume was calculated with NIH Image J software using continuous CT images. After 2-4 treatment cycles, 23 (70%) patients showed reductions in their ascitic volumes of >50%. Ascites disappeared completely in 8 patients and were markedly reduced (to <3% of the original volume) in 4 of the 9 patients (44%) who initially had massive (>2,500 ml) ascites. Median overall survival was significantly better in patients with ascitic reduction. Weekly intravenous and intraperitoneal PTX combined with S-1 was highly effective in gastric cancer with malignant ascites. The change in ascitic fluid volumes determined by CT image measurements is a useful predictor of outcome in these patients.
authors.affiliation: Department of Surgical Oncology, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. kitayama-1SU @ h.u-tokyo.ac.jp
authors.forename: Joji
authors.initials: J
authors.lastname: Kitayama
authors.forename: Hironori
authors.initials: H
authors.lastname: Ishigami
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kaisaki
authors.forename: Akio
authors.initials: A
authors.lastname: Hidemura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kato
authors.forename: Kensuke
authors.initials: K
authors.lastname: Otani
authors.forename: Takao
authors.initials: T
authors.lastname: Kamei
authors.forename: Daisuke
authors.initials: D
authors.lastname: Soma
authors.forename: Hideyo
authors.initials: H
authors.lastname: Miyato
authors.forename: Hiroharu
authors.initials: H
authors.lastname: Yamashita
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nagawa
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001201:Ascites / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007274:Injections, Intraperitoneal; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D010534:Peritoneal Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000556:secondary; D013274:Stomach Neoplasms / Q000473:pathology*; D016019:Survival Analysis; D005641:Tegafur / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D017239:Paclitaxel