Weekly Intravenous and Intraperitoneal Paclitaxel Combined with S-1 for Malignant Ascites due to Advanced Gastric Cancer
Weekly Intravenous and Intraperitoneal Paclitaxel Combined with S-1 for Malignant Ascites due to Advanced Gastric Cancer
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DOI：
10.1159/000290955
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发表时间：
2010-01-01
期刊：
影响因子：
3.5
通讯作者：
Nagawa, Hirokazu
中科院分区：
文献类型：
--
作者：
Kitayama, Joji;Ishigami, Hironori;Nagawa, Hirokazu
胃癌引起的恶性腹水对化疗有抵抗力，预后不良。对33例经CT诊断为腹腔积液的胃癌患者，采用紫杉醇（PTX）腹腔注射治疗，观察其疗效。在第1天和第8天通过皮下放置的腹膜内导管进行静脉内（50 mg/m2）和腹膜内（20 mg/m2）PTX同步给药，从第1天至第14天连续14天以80 mg/m2/天的剂量每日两次给予S-1，然后停药7天。使用NIH Image J软件使用连续CT图像计算腹水体积。在2-4个治疗周期后，23例（70%）患者显示腹水体积减少> 50%。8例患者腹水完全消失，腹水明显减少（至2,500 ml）。腹水缩小的患者中位总生存期明显更好。紫杉醇联合替吉奥每周静脉及腹腔注射治疗胃癌腹水疗效显著。通过CT图像测量确定的腹水量的变化是这些患者预后的有用预测因素。版权所有（C）2010 S. Karger AG，巴塞尔
Malignant ascites caused by gastric cancer are chemotherapy resistant and carry a poor prognosis. The efficacy of a regimen including intraperitoneal paclitaxel (PTX) was evaluated in 33 gastric cancer patients with ascetic fluid in the peritoneal cavity diagnosed with computed tomography (CT) scanning. Synchronous administration of intravenous (50 mg/m(2)) and intraperitoneal (20 mg/m(2)) PTX was performed via a subcutaneously placed intraperitoneal catheter on days 1 and 8, and S-1 was administered twice daily at 80 mg/m(2) /day for 14 consecutive days from day 1 to day 14, followed by 7 days of rest. The ascitic fluid volume was calculated with NIH Image J software using continuous CT images. After 2-4 treatment cycles, 23 (70%) patients showed reductions in their ascitic volumes of > 50%. Ascites disappeared completely in 8 patients and were markedly reduced (to 2,500 ml) ascites. Median overall survival was significantly better in patients with ascitic reduction. Weekly intravenous and intraperitoneal PTX combined with S-1 was highly effective in gastric cancer with malignant ascites. The change in ascitic fluid volumes determined by CT image measurements is a useful predictor of outcome in these patients. Copyright (C) 2010 S. Karger AG, Basel