演題

Intraperitoneal chemotherapy with paclitaxel for treatment of gastric cancer with peritoneal metastasis

[演者] 山口 博紀:1
[著者] 石神 浩徳:2, 北山 丈二:1, 渡邉 聡明:1
1:東京大学腫瘍外科, 2:東京大学外来化学療法部

There is no standard treatment method for peritoneal carcinomatosis of gastric cancer. We have performed intraperitoneal (ip) chemotherapy using paclitaxel (PTX) combined with gastrectomy for gastric cancer with peritoneal metastasis. PTX was administered intraperitoneally via a subcutaneously implanted intraperitoneal access port. Herein we report our results of ip chemotherapy. 1) S-1 + PTX ip iv: Phase I trial revealed the recommended dose of ip PTX was 20mg/m2. In phase II trial for 40 patients with P1 and/or CY1, the 1-year OS rate and median survival time (MST) were 78% and 23.6 months respectively. In other phase II trial for 35 patients with P1, 1-year OS rate and MST were 77% and 17.6 months respectively. Phase III study (PHOENIX-GC trial) is now ongoing.2) SOX+PTX ip: Phase I study revealed the recommended dose of PTX ip was 40mg/m2. Phase II study is now ongoing.3) Gastrectomy after ip chemotherapy: In 100 gastric cancer patients with peritoneal metastasis, 62 patients received gastrectomy after confirming ip chemotherapy was effective for peritoneal metastasis with 2nd look laparoscopy. There were no severe postoperative complications. R0 resection was performed in 44 cases. Median disease free survival time and MST were 19.6 months and 34.5 months respectively. PTX ip chemotherapy combined with gastrectomy is effective for gastric cancer with peritoneal metastasis.
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