Recently, it became possible to reduce the size of
tumors in patients with advanced or relapsed
gastric cancer by
chemotherapy with the combination of several kinds of anti-
cancer drugs which are all effective and allowed for use with
gastric cancer patients. However,
chemotherapy alone can not cure patients with advanced
gastric cancer that was shown to improve median survival time (MST), compared with patients provided with the best supportive care (BSC). According to reports from Europe, US and Japan,the MST of patients with advanced
gastric cancer and those with peritoneal expansion treated by
chemotherapy is almost 7-12 months and 5-6 months,respectively, both of which are short and unsatisfactory. From March 2002, we started to treat patients with advanced
gastric cancer (stage IV) with a new regimen; intermittent dosage of
5-FU (-->S-1), CDDP and
paclitaxel utilizing the difference of cell cycle between normal and
cancer cells (intermittent FP . weekly PTX). In the present study, therefore, we analyzed advanced
gastric cancer patients with peritoneal expansion (9 cases, 4 with cancerous
peritonitis) treated with this regimen. The results were as follows. The one-and 2-year survival rate was 55.6% and 27.8%, respectively, and the MST was 14 months. Four patients (44.4%) had hematological toxicities over grade 3. All of them had
anemia (3 cases) and
neutropenia (3 cases). Toxicities of
thrombocytopenia were all under grade 1 and nonhematological toxicities were all under grade 2, which were clinically manageable. These results, although the sample was small, suggested that this may contribute to the extension of survival time of patients with stage IV advanced
gastric cancer with peritoneal expansion.