Effects of Neoadjuvant Intraperitoneal/Systemic Chemotherapy (Bidirectional Chemotherapy) for the Treatment of Patients with Peritoneal Metastasis from Gastric Cancer
Novel multidisciplinary treatment combined with neoadjuvant intraperitoneal-systemic chemotherapy protocol (NIPS) and peritonectomy was developed. Ninety-six patients were enrolled. Peritoneal wash cytology was performed before and after NIPS through a port system. Patients were treated with 60 mg/m...
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Series: | International Journal of Surgical Oncology |
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doaj-89addc8652384ac59a37444dad3bfd192020-11-24T22:53:43ZengHindawi LimitedInternational Journal of Surgical Oncology2090-14022090-14102012-01-01201210.1155/2012/148420148420Effects of Neoadjuvant Intraperitoneal/Systemic Chemotherapy (Bidirectional Chemotherapy) for the Treatment of Patients with Peritoneal Metastasis from Gastric CancerYutaka Yonemura0Ayman Elnemr1Yoshio Endou2Haruaki Ishibashi3Akiyoshi Mizumoto4Masahiro Miura5Yan Li6NPO Organization to Support Peritoneal Surface Malignancy Treatment, Osaka, Kishiwada 596-0032, JapanNPO Organization to Support Peritoneal Surface Malignancy Treatment, Osaka, Kishiwada 596-0032, JapanDepartment of Experimental Therapeutics, Cancer Research Institute, Kanazawa University, Kanazawa 920-1192, JapanNPO Organization to Support Peritoneal Surface Malignancy Treatment, Osaka, Kishiwada 596-0032, JapanDepartment of Surgery, Kusatsu General Hospital, Shiga, Kusatsu 525-8585, JapanDepartment of Anatomy, School of Medicine, Oita University, Oita 870-1192, JapanDepartment of Oncology, Zhongnan Hospital, Cancer Center of Wuhan University, Wuhan 430072, ChinaNovel multidisciplinary treatment combined with neoadjuvant intraperitoneal-systemic chemotherapy protocol (NIPS) and peritonectomy was developed. Ninety-six patients were enrolled. Peritoneal wash cytology was performed before and after NIPS through a port system. Patients were treated with 60 mg/m2 of oral S-1 for 21 days, followed by a 1-week rest. On days 1, 8, and 15, 30 mg/m2 of Taxotere and 30 mg/m2 of cisplatin with 500 mL of saline were introduced through the port. NIPS is done 2 cycles before surgery. Three weeks after NIPS, 82 patients were eligible to intend cytoreductive surgery (CRS) by gastrectomy + D2 dissection + periotnectomy to achieve complete cytoreduction. Sixty-eight patients showed positice cytology before NIPS, and the positive cytology results became negative in 47 (69%) patients after NIPS. Complete pathologic response on PC after NIPS was experienced in 30 (36.8%) patients. Stage migration was experienced in 12 patients (14.6%). Complete cytoreduction was achieved in 58 patients (70.7%). By the multivariate analysis, complete cytoreduction and pathologic response became a significantly good survival. However the high morbidity and mortality, stringent patient selection is important. The best indications of the therapy are patients with good pathologic response and PCI≤6, which are supposed to be removed completely by peritonectomy.http://dx.doi.org/10.1155/2012/148420 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yutaka Yonemura Ayman Elnemr Yoshio Endou Haruaki Ishibashi Akiyoshi Mizumoto Masahiro Miura Yan Li |
spellingShingle |
Yutaka Yonemura Ayman Elnemr Yoshio Endou Haruaki Ishibashi Akiyoshi Mizumoto Masahiro Miura Yan Li Effects of Neoadjuvant Intraperitoneal/Systemic Chemotherapy (Bidirectional Chemotherapy) for the Treatment of Patients with Peritoneal Metastasis from Gastric Cancer International Journal of Surgical Oncology |
author_facet |
Yutaka Yonemura Ayman Elnemr Yoshio Endou Haruaki Ishibashi Akiyoshi Mizumoto Masahiro Miura Yan Li |
author_sort |
Yutaka Yonemura |
title |
Effects of Neoadjuvant Intraperitoneal/Systemic Chemotherapy (Bidirectional Chemotherapy) for the Treatment of Patients with Peritoneal Metastasis from Gastric Cancer |
title_short |
Effects of Neoadjuvant Intraperitoneal/Systemic Chemotherapy (Bidirectional Chemotherapy) for the Treatment of Patients with Peritoneal Metastasis from Gastric Cancer |
title_full |
Effects of Neoadjuvant Intraperitoneal/Systemic Chemotherapy (Bidirectional Chemotherapy) for the Treatment of Patients with Peritoneal Metastasis from Gastric Cancer |
title_fullStr |
Effects of Neoadjuvant Intraperitoneal/Systemic Chemotherapy (Bidirectional Chemotherapy) for the Treatment of Patients with Peritoneal Metastasis from Gastric Cancer |
title_full_unstemmed |
Effects of Neoadjuvant Intraperitoneal/Systemic Chemotherapy (Bidirectional Chemotherapy) for the Treatment of Patients with Peritoneal Metastasis from Gastric Cancer |
title_sort |
effects of neoadjuvant intraperitoneal/systemic chemotherapy (bidirectional chemotherapy) for the treatment of patients with peritoneal metastasis from gastric cancer |
publisher |
Hindawi Limited |
series |
International Journal of Surgical Oncology |
issn |
2090-1402 2090-1410 |
publishDate |
2012-01-01 |
description |
Novel multidisciplinary treatment combined with neoadjuvant intraperitoneal-systemic chemotherapy protocol (NIPS) and peritonectomy was developed. Ninety-six patients were enrolled. Peritoneal wash cytology was performed before and after NIPS through a port system. Patients were treated with 60 mg/m2 of oral S-1 for 21 days, followed by a 1-week rest. On days 1, 8, and 15, 30 mg/m2 of Taxotere and 30 mg/m2 of cisplatin with 500 mL of saline were introduced through the port. NIPS is done 2 cycles before surgery. Three weeks after NIPS, 82 patients were eligible to intend cytoreductive surgery (CRS) by gastrectomy + D2 dissection + periotnectomy to achieve complete cytoreduction. Sixty-eight patients showed positice cytology before NIPS, and the positive cytology results became negative in 47 (69%) patients after NIPS. Complete pathologic response on PC after NIPS was experienced in 30 (36.8%) patients. Stage migration was experienced in 12 patients (14.6%). Complete cytoreduction was achieved in 58 patients (70.7%). By the multivariate analysis, complete cytoreduction and pathologic response became a significantly good survival. However the high morbidity and mortality, stringent patient selection is important. The best indications of the therapy are patients with good pathologic response and PCI≤6, which are supposed to be removed completely by peritonectomy. |
url |
http://dx.doi.org/10.1155/2012/148420 |
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