Tsujitani S, Okuyama T, Watanabe A, Abe Y, Maehara Y, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Anticancer Res. 1993 Sep-Oct;13(5C):1831-4.
Forty-five patients with gastric cancer having peritoneal seeding but no liver metastases received intraperitoneal cisplatin, 50 to 200 mg (89.4 mg on average), immediately after gastrectomy, while 37 controls were treated with intravenous mitomycin C on the day of their gastrectomy and daily oral tegafur (N1-(2'-tetrahydrofuryl)-5-fluorouracil) postoperatively. Side effects and postoperative complications after intraperitoneal cisplatin were limited. The postoperative survival rate was better in patients given cisplatin than in the controls (P < 0.05). A significant difference in survival was seen particularly in those with the undifferentiated type of gastric cancer or 'massive' peritoneal seeding. The succinate dehydrogenase inhibition test for chemosensitivity to drugs revealed that tissues obtained from the undifferentiated type of gastric cancer or foci of peritoneal seeding were more sensitive to cisplatin than to mitomycin C or adriamycin. These results demonstrate that intraperitoneal cisplatin after gastrectomy is safe and suitable for the treatment of patients with gastric cancer and peritoneal seeding.
45例有腹膜种植但无肝转移的胃癌患者在胃切除术后立即接受腹腔内顺铂治疗，剂量为50至200毫克（平均89.4毫克），而37例对照患者在胃切除当天接受静脉注射丝裂霉素C治疗，术后每日口服替加氟（N1-(2'-四氢呋喃基)-5-氟尿嘧啶）。腹腔内顺铂治疗后的副作用和术后并发症有限。接受顺铂治疗的患者术后生存率高于对照组（P<0.05）。特别是在未分化型胃癌或“弥漫性”腹膜种植患者中，生存率存在显著差异。对药物化疗敏感性的琥珀酸脱氢酶抑制试验表明，从未分化型胃癌或腹膜种植灶获取的组织对顺铂比对丝裂霉素C或阿霉素更敏感。这些结果表明，胃切除术后腹腔内注射顺铂是安全的，适用于治疗有腹膜种植的胃癌患者。
