Abstract
4236 Background: The aim of this study is to clarify the survival benefit of sequential chemotherapy of S-1/weekly paclitaxel in patients (pts) with peritoneal metastasis of gastric cancer. Methods: A total of 91 gastric cancer pts, including synchronous peritoneal metasitasis in 66 and metachronous one in 25 pts, were treated with S-1 (80mg/m2/day for 4 weeks with 2 weeks rest) until progression. When S-1 was failed, pts then underwent paclitaxel (80 mg/m2 at day 1, 8, 15 every 28 days) if applicable. Of 66 synchronous disease, 9 were only positive for intra-peritoneal lavage cytology. Median age was 64 years (27–85). Fifteen pts had undergone prior chemotherapy. Performance status (PS) was 0 in 22 pts, 1 in 49 pts, and 2 in 20 pts. Results: S-1 was discontinued because of toxicity in 10 pts. Paclitaxel was applicable for 47 pts including PS0–2 in 36 pts, and PS3 in 11 pts. Overall median survival time (O-MST) after the initiation of S-1 was 300 days. O-MST was 256 days in pts with prior chemotherapy and 329 days in pts without one (p=0.02), and 356 days for PS0/1 and 234 days for PS2 (p=0.00), respectively. Median time to progression of S-1 was 173 days. MST after paclitaxel (P-MST) was 155 days. P-MST was 222 days and O-MST was 507 days in pts with PS 0/1/2 when paclitaxel was started. Conclusions: Sequential chemotherapy of S-1/weekly paclitaxel may benefit pts with peritoneal metastases, especially for pts with good PS. No significant financial relationships to disclose.
Published Version
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