[Neoadjuvant chemotherapy of far advanced gastric cancer--effect of preoperative chemotherapy by PMUE (CDDP, MMC, UFT, etoposide].

Preoperative chemotherapy with CDDP, MMC, UFT and etoposide (PMUE) was performed on cases of far advanced gastric cancer whose curative resection was impossible. The therapy comprised 1-5 courses of either intravenous or arterial infusion, or intraperitoneal administration of CDDP 75 mg/m2, MMC 10 mg/body and Etoposide 50 X 3 mg/body at 3-week intervals in combined use of UFT 400 mg/body. The effect of the preoperative PMUE therapy was CR, PR, NC and PD in 0, 7, 1 and 0 cases, respectively, the rate of effectiveness being 88% (7/8). 5 of 7 cases with PR were operated on, 2 cases succeeded in curative resection, but 3 cases did not. Histological judgment of effects confirmed Grade II-a, II-b and III in 2, 2 and 1 cases, respectively; these 5 cases further received 1-4 courses of PMUE therapy as postoperative adjuvant chemotherapy and are still alive at P.S. 0-2, suggesting the great efficacy of this PMUE therapy as a neoadjuvant chemotherapy for improvement in prognosis in far advanced gastric cancer. Abnormally high values of the tumor marker were noted in 5 of 8 cases, 4 of which had tumor marker values lowered in exponential function by the preoperative chemotherapy, which constituted an effective index in determining chemotherapeutic effects and the determination of the operative timing.