Abstract
170 Background: The prognosis of gastric cancer with peritoneal metastases remains dismal. Ishigami et al. have recently published a phase III study (PHOENIX-GC) aimed at clinical efficacy of intraperitoneal paclitaxel (PTX), which established intraperitoneal chemotherapy as a decent option for gastric cancer with peritoneal dissemination. According to this report, we have used various regimens of intraperitoneal chemotherapy, adjusted mainly based on previous treatments. Methods: Data from 82 patients with gastric cancer with peritoneal metastases who underwent intraperitoneal chemotherapy in our institute from February 2012 to July 2017 were retrospectively analyzed. The progression free survival (PFS), the overall survival (OS) and the 1-year survival rate were stratified by prior treatments. Results: Of the 82 patients, 38 (46.3%) were chemotherapy-naïve. The intraperitoneal regimens were assigned mainly according to the prior treatment: intraperitoneal PTX plus S-1/PTX was the most frequent (39 cases), followed by intraperitoneal PTX plus intravenous PTX (17 cases), intraperitoneal PTX only (6 cases), and the rest. The median PFS for the chemotherapy-naïve group and the previously treated group was 6.9 and 4.1 months, and the median OS was 12.8 and 7.9 months, and the 1-year survival rate was 72.2% and 34.4%, respectively. 10 patients (12.2%) achieved conversion surgery after confirmed complete response in the peritoneal metastases. Among these 10 patients, the median survival time is 22.7 months (7.6+-47.7). Adverse events were also analyzed for each regimen, as for intraperitoneal PTX plus S-1/PTX, leukopenia, neutropenia and anemia occurred frequently. All regimens were comprehensively tolerable, and there were no treatment-related deaths. Conclusions: Intraperitoneal chemotherapy is a promising and feasible option for gastric cancer with peritoneal dissemination. There were several cases with long-term prognosis where conversion surgery was achieved.
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