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Journal of Gastrointestinal Surgery

, Volume 16, Issue 12, pp 2190–2196 | Cite as

Phase II Study of Single Intraperitoneal Chemotherapy Followed by Systemic Chemotherapy for Gastric Cancer with Peritoneal Metastasis

  • Motohiro ImanoEmail author
  • Atsushi Yasuda
  • Tatsuki Itoh
  • Takao Satou
  • Ying-Feng Peng
  • Hiroaki Kato
  • Masayuki Shinkai
  • Masahiro Tsubaki
  • Yasutaka Chiba
  • Takushi Yasuda
  • Haruhiko Imamoto
  • Shozo Nishida
  • Yoshifumi Takeyama
  • Kiyokata Okuno
  • Hiroshi Furukawa
  • Hitoshi Shiozaki
Original Article

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/m2) was administered intraperitoneally at staging laparoscopy. Within 7 days, patients received systemic chemotherapy with S-1 (80 mg/m2/day on days 1–14) plus paclitaxel (50 mg/m2 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.

Keywords

Gastric cancer Peritoneal metastasis Intraperitoneal chemotherapy Gastrectomy 

Notes

Acknowledgments

The authors would like to express their appreciation to Dr. Harumasa Ohyanagi, Vice Board Director of the University of KinDAI Himeji, for his expert comments on the manuscript. We also wish to thank Ms. Fusako Kamada for her technical assistance.

Funding

The study was not supported by any grant.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • Motohiro Imano
    • 1
    • 2
    Email author
  • Atsushi Yasuda
    • 1
  • Tatsuki Itoh
    • 3
  • Takao Satou
    • 3
  • Ying-Feng Peng
    • 1
  • Hiroaki Kato
    • 1
  • Masayuki Shinkai
    • 1
  • Masahiro Tsubaki
    • 4
  • Yasutaka Chiba
    • 5
  • Takushi Yasuda
    • 1
  • Haruhiko Imamoto
    • 1
  • Shozo Nishida
    • 4
  • Yoshifumi Takeyama
    • 1
    • 2
  • Kiyokata Okuno
    • 1
  • Hiroshi Furukawa
    • 1
  • Hitoshi Shiozaki
    • 1
  1. 1.SurgeryKinki University Faculty of MedicineOsaka-SayamaJapan
  2. 2.Cancer CenterKinki University HospitalOsaka-SayamaJapan
  3. 3.PathologyKinki University Faculty of MedicineOsaka-SayamaJapan
  4. 4.Division of PharmacotherapyKinki University Faculty of PharmacyHigashi-OsakaJapan
  5. 5.Division of Biostatistics, Clinical Research CenterKinki University Faculty of MedicineOsaka-SayamaJapan

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