title: Phase II study of single intraperitoneal chemotherapy followed by systemic chemotherapy for gastric cancer with peritoneal metastasis.
abstract: BACKGROUND
  We conducted a phase II study involving a single administration of intraperitoneal chemotherapy with paclitaxel followed by sequential systemic chemotherapy with S-1+ paclitaxel for advanced gastric cancer patients with peritoneal metastasis.
  
  
  METHODS
  Gastric cancer patients with peritoneal metastasis were enrolled. Paclitaxel (80 mg/m(2)) was administered intraperitoneally at staging laparoscopy. Within 7 days, patients received systemic chemotherapy with S-1 (80 mg/m(2)/day on days 1-14) plus paclitaxel (50 mg/m(2) on days 1 and 8), followed by 7-days rest. The responders to this chemotherapy underwent second-look laparoscopy, and gastrectomy with D2 lymph node dissection was performed in patients when the disappearance of peritoneal metastasis had been confirmed. The primary endpoint of the study was overall survival rate.
  
  
  RESULTS
  Thirty-five patients were enrolled. All patients were confirmed as having localized peritoneal metastasis by staging laparoscopy. Eventually, gastrectomy was performed in 22 patients. The median survival time of the total patient population and those patients in which gastrectomy was performed was 21.3 and 29.8 months, respectively. The overall response rate was 65.7 % for all patients. The frequent grade 3/4 toxic effects included neutropenia and leukopenia.
  
  
  CONCLUSIONS
  Sequential intraperitoneal and intravenous paclitaxel plus S-1 was well tolerated in gastric cancer patients with peritoneal metastasis.
authors.affiliation: Surgery, Kinki University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka, 589-8511, Japan. imano@med.kindai.ac.jp
authors.forename: Motohiro
authors.initials: M
authors.lastname: Imano
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yasuda
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Itoh
authors.forename: Takao
authors.initials: T
authors.lastname: Satou
authors.forename: Ying-Feng
authors.initials: YF
authors.lastname: Peng
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kato
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shinkai
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsubaki
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Chiba
authors.forename: Takushi
authors.initials: T
authors.lastname: Yasuda
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Imamoto
authors.forename: Shozo
authors.initials: S
authors.lastname: Nishida
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Takeyama
authors.forename: Kiyokata
authors.initials: K
authors.lastname: Okuno
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furukawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shiozaki
mesh_terms: D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007322:Instillation, Drug; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D010537:Peritoneum; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel