Intraperitoneal Infusion of Docetaxel Combined with Oral S-1 for Metastatic or Recurrent Gastric Cancer Patients with Peritoneal Metastasis

Introduction Though many modalities of chemotherapy have been tried for metastatic or recurrent gastric cancer (GC) patients (pts) with peritoneal dissemination, it remains uncontrollable yet. Docetaxel (DOC) and S-1 have different mechanisms of anti-tumor activity and they are effective against advanced GC. Recently, intraperitoneal administration (IP) of DOC has proved to be effective for peritoneal dissemination. Material and methods Eligibility included metastatic or recurrent GC with peritoneal dissemination, capability of oral intake, adequate organ function, and good PS (0-2). IP catheters were placed for all patients after histological confirmation of peritoneal dissemination by laparoscopy or laparotomy. The treatment of oral S-1 (80 mg/m2 daily day 1-14, q4w) and DOC (35 ∼ 45 mg/m2 ip day 1 and 15, q4w) was repeated every 4 weeks until disease progression or unacceptable toxicities. Results Between Aug. 2001 and Mar. 2012, 52 pts (P3; 25, P2; 4, P0CY1; 23) including 27 males and 25 females, with a median age of 59 (21-80) were enrolled. Total No. of cycle was 334, the median No. of cycle was 6 (2-15), reduced courses were 109, delayed courses (>7 days) were 46. Reductive gastrectomy was performed for 7 cases. The grade 3/4 toxicities were neutropenia (5.8%), anemia (7.7%), anorexia (13.5%), fatigue (9.6%), and diarrhea (9.6%), respectively. However febrile neutropenia, grade 4 non-hematological toxicities and TRD were not observed. The incidence of cancer cell positive cytology (CY1) changed to negative (CY0) was 61.0% (25/41), but no obvious peritoneal metastasis (P1-P3) disappeared. The MST was 11.1 months and l-, 2- and 3-year survival rate was 48.1%, 23.1 and 9.6%, respectively. Conclusions With respect to low toxicity and high feasibility, IP infusion of DOC with oral S-1 is an alternate treatment for metastatic or recurrent GC with peritoneal dissemination. Disclosure All authors have declared no conflicts of interest.