Safety of intraperitoneal administration of paclitaxel after gastrectomy with en-bloc D2 lymph node dissection.

Abstract

BACKGROUND:

The aim of this study was to examine the safety, pharmacokinetics, and cytological efficacy against free intraperitoneal cancer cells of intraperitoneal chemotherapy (IPC) with paclitaxel after gastrectomy with en-bloc D2 lymph node dissection (GD2) in cases of gastric cancer with peritoneal carcinomatosis (PC) and/or positive cytological findings in peritoneal washings (CFPW).

METHODS:

Twenty-one patients with gastric cancer with PC and/or positive CFPW who underwent GD2 were treated with early, post-operative, intraperitoneal paclitaxel. Intra-chemotherapeutic toxicity and operative complication were measured using the common toxicity criteria of the National Cancer Institute, version 3.0. Intraperitoneal and plasma paclitaxel concentrations were measured using a high-performance liquid chromatography assay.

RESULTS:

Grade 3 anemia occurred in two patients (9.5%) and neutropenia was observed in three patients (14.3%). No grade 4 toxicity was observed. A grade 2 operative complication was a superficial surgical site infection (4.8%) that was treated with antibiotics. Cytologically, no viable cancer cells were observed in the intra-abdominal fluid 24 hr after intraperitoneal administration of paclitaxel. The intraperitoneal/plasma area under the drug concentration-time curve (AUC) ratio was 596.9:1.

CONCLUSION:

IPC with paclitaxel after GD2 is a safe and cytologically effective treatment modality for free intraperitoneal cancer cells. However, additional data are required to determine the effect on survival.

• Authors: Motohiro Imano, Haruhiko Imamoto, Tatsuki Itoh, Takao Satou, Ying-Feng Peng, Atsushi Yasuda, Hiroaki Kato, Osamu Shiraishi, Masayuki Shinkai, Takushi Yasuda, Yoshifumi Takeyama, Kiyokata Okuno, Hitoshi Shiozaki
• Journal: Journal of surgical oncology (J Surg Oncol) Vol. 105 Issue 1 Pg. 43-7 (Jan 2012) ISSN: 1096-9098 [Electronic] United States
• PMID: 21837682 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 Wiley Periodicals, Inc.

Chemical References

• Antineoplastic Agents, Phytogenic
• Paclitaxel

Topics

• Adenocarcinoma (mortality, secondary, therapy)
• Adult
• Aged
• Antineoplastic Agents, Phytogenic (therapeutic use)
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Gastrectomy
• Humans
• Injections, Intraperitoneal
• Lymph Node Excision
• Lymphatic Metastasis
• Male
• Middle Aged
• Neoplasm Staging
• Paclitaxel (therapeutic use)
• Peritoneal Neoplasms (mortality, secondary, therapy)
• Postoperative Complications
• Prospective Studies
• Safety
• Stomach Neoplasms (mortality, pathology, therapy)
• Survival Rate
• Treatment Outcome