Department of Surgical Oncology, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. kitayama-1SU @ h.u-tokyo.ac.jp
Oncology. 2010;78(1):40-6. doi: 10.1159/000290955. Epub 2010 Mar 3.
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 <3% of the original volume) in 4 of the 9 patients (44%) who initially had massive (>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.
胃癌引起的恶性腹水对化疗耐药，预后不良。在 33 例经计算机断层扫描（CT）诊断为腹腔积液的胃癌患者中评估了包括腹腔内紫杉醇（PTX）在内的方案的疗效。在第 1 天和第 8 天，通过皮下放置的腹腔内导管同时给予静脉内（50mg/m2）和腹腔内（20mg/m2）PTX，从第 1 天到第 14 天每天两次给予 S-1，剂量为 80mg/m2/天，持续 14 天，然后休息 7 天。使用 NIH Image J 软件根据连续 CT 图像计算腹水体积。在 2-4 个治疗周期后，23 名（70%）患者的腹水体积减少了>50%。8 名患者的腹水完全消失，9 名最初有大量（>2500ml）腹水的患者中，4 名（44%）患者的腹水明显减少（至原始体积的<3%）。腹水减少的患者中位总生存期明显更好。每周静脉内和腹腔内 PTX 联合 S-1 对恶性腹水的胃癌非常有效。CT 图像测量确定的腹水变化量是这些患者预后的有用预测指标。
