title: [Multidisciplinary treatment for gastric cancer with peritoneal metastasis].
abstract: The standard of care for gastric cancer with peritoneal metastasis is systemic chemotherapy. However, there is no chemotherapy regimen with a sufficient level of evidence supporting its effectiveness, and thus S-1 plus cisplatin(CDDP), which is regarded as the standard regimen for advanced metastatic gastric cancer, is widely applied. Meanwhile, the efficacy of intraperitoneal(IP)administration of taxanes has been verified, and the novel multidisciplinary treatment combining chemotherapy and surgery is now being tested. We developed a combination chemotherapy regimen of S -1, weekly intravenous and IP paclitaxel(PTX), and determined the recommended dose of IP PTX to be 20mg/m2 in our phase I study. In our phase II study, the median survival time(MST)of 40 patients enrolled was 23. 6 months, and peritoneal cytology turned negative for 86% of 28 patients. Moreover, we performed gastrectomy on 60 patients after the disappearance or obvious shrinkage of peritoneal metastasis, and the MST was 34. 5 months. Multidisciplinary treatment combining IP-containing chemotherapy and surgery is safe and effective for gastric cancer patients with peritoneal metastasis. We have started a phase III trial(PHOENIX-GC trial)comparing our IP regimen to S-1 plus CDDP.
authors.affiliation: Dept. of Outpatient Chemotherapy, The University of Tokyo, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Ishigami
authors.forename: Joji
authors.initials: J
authors.lastname: Kitayama
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Emoto
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000628:therapy*; D013274:Stomach Neoplasms / Q000473:pathology / Q000628:therapy*