Yamaguchi Hironori, Ishigami Hironori, Kitayama Joji
Dept. of Clinical Oncology, Jichi Medical University.
Gan To Kagaku Ryoho. 2016 Dec;43(13):2481-2485.
Peritoneal metastasis of gastric cancer remains a refractory disease, and the standard treatment strategy is still unclear. Intraperitoneally administered paclitaxel(PTX)remains in the intraperitoneal(IP)cavity for a long time and directly infiltrates peritoneal metastatic nodules, thereby producing antitumor effects. We designed an IP chemotherapy regimen of S-1 combined with weekly intravenous(IV)and IP PTXadministration. In our phase I study, the recommended dose of IP PTXwas determined to be 20mg/m2. In our phase II study for patients with P1(macroscopic peritoneal metastasis-positive)or CY1 (cytology-positive)gastric cancer, the 1-year overall survival(OS)rate was 78%and the median survival time(MST)was 23.6 months. In another phase II study of patients with P1 gastric cancer, the 1-year OS rate was 77%and the MST was 17.1 months. A phase III PHOENIX-GC trial comparing IP chemotherapy to S-1 plus cisplatin has recently been completed. Phase II studies of the IP administration of docetaxel have also shown favorable results. Recently, the results of several clinical studies investigating the effects of S-1 combined with weekly IV and IP PTXadministration for peritoneal metastasis of pancreatic cancer have been published.
胃癌腹膜转移仍然是一种难治性疾病,标准治疗策略仍不明确。腹腔内注射紫杉醇(PTX)可在腹腔(IP)内长时间留存,并直接浸润腹膜转移结节,从而产生抗肿瘤作用。我们设计了一种S-1联合每周静脉注射(IV)及腹腔内注射PTX的腹腔化疗方案。在我们的I期研究中,腹腔内注射PTX的推荐剂量确定为20mg/m²。在我们针对P1(宏观腹膜转移阳性)或CY1(细胞学阳性)胃癌患者的II期研究中,1年总生存率(OS)为78%,中位生存时间(MST)为23.6个月。在另一项针对P1胃癌患者的II期研究中,1年OS率为77%,MST为17.1个月。一项比较腹腔化疗与S-1加顺铂的III期PHOENIX-GC试验最近已完成。多西他赛腹腔给药的II期研究也显示出良好结果。最近,几项关于S-1联合每周静脉注射及腹腔内注射PTX对胰腺癌腹膜转移影响的临床研究结果已发表。