Extended outcomes of intraperitoneal and systemic chemotherapy for gastric cancer with peritoneal metastases.

125Background: Peritoneal metastasis is common in gastric cancer. It is difficult to treat and carries a grave prognosis. Studies have shown increased drug concentration in the peritoneal cavity when chemotherapy is administered intraperitoneally (IP). We had previously published early results on IP paclitaxel plus XELOX for such patients and now present our longer term data. Methods: Patients with unresectable and/or recurrent gastric adenocarcinoma with peritoneal dissemination and/or positive peritoneal washing cytology, not previously-treated or received prior systemic therapy > 180 days ago and ECOG ≤2 are eligible. Patients were treated with 8 cycles of paclitaxel 40 mg/m2 IP on days 1 and 8, oxaliplatin 100 mg/m2 IV on day 1 and capecitabine 1000 mg/m2 b.i.d. PO for 2 weeks followed by 1 week of rest. The primary endpoint is 1-year overall survival rate and the secondary endpoints are safety, response rate and peritoneal cytological response. Patients who subsequently have no distant metastases, wi...