演題抄録

FACO International Workshop

開催概要
開催回
第53回・2015年・京都
 

Multidisciplinary treatment for patients with massive malignant ascites with peritoneal metastasis of gastric cancer: Intraperitoneal paclitaxel with oral S-1 combined with CART

演題番号 : FWS7-3

[筆頭演者]
Kitayama Joji:1 
[共同演者]
Ishigami Hironori:1、Yamaguchi Hironori:1

1:Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo

 

Background: We have treated the patients with peritoneal metastasis of gastric cancer (GC) with combination chemotherapy including intraperitoneal (IP) paclitaxel (PTX), which results in a marked improvement of outcome with median survival of around 2 years. Massive malignant ascites are often associated with peritoneal metastasis of GC. Cell-free and Concentrated Ascites Reinfusion Therapy (CART) is often used to control the massive ascites which results in excellent palliation. In this study, we retrospectively studied the safety and efficacy of IP chemotherapy combined with CART in patients with massive malignant ascites of GC.
Methods: Paclitaxel (PTX) was administered via IP access port implanted in subcutaneous space. If patient had massive ascites at the beginning of treatment, paracentesis was performed through a percutaneous IP catheter and CART was performed. PTX was administered through the catheter until the ascites diminished. PTX was administered IP at 20 mg/m2 from the subcutaneous implanted peritoneal access ports as well as IV at 50 mg/m2 on days 1 and 8. S-1 was administered at 80 mg/m2/day for 14 consecutive days, followed by 7 days rest.
Results: A total of 127 CART procedures in 30 patients were analyzed. The average volume of processed ascites was 3.1 L, which was concentrated to 0.33 L containing 85.5 g protein on average. Significant increase in the urine volume, serum total protein and albumin level was found after CART procedure. The MST and 1-year survival of 30 patients who received IP chemotherapy combined with CART procedure was 10.2 months and 43.3% respectively. Two patients received salvage gastrectomy after apparent downstage and survived for 15 and 33 months. Conclusions: IP chemotherapy combined with CART is a promising strategy even for patients with massive malignant ascites originated from peritoneal metastasis of GC.

キーワード

臓器別:胃・十二指腸

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