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At least 91 records · Page 5Linked to original sources
PubMed1987

Chemotherapy for carcinomatous peritonitis and pleuritis with MMC-CH, mitomycin C adsorbed on activated carbon particles. Clinical trials.

A new drug dosage form comprising activated carbon particles adsorbing mitomycin C (MMC-CH) is designed to slowly release its components, and has affinity for the tumor surface and lymph nodes and a tendency to stay long in the local portion. The therapeutic index of MMC-CH in experimental carcinomatous peritonitis is 3.1 times as high as that of MMC-solution. In clinical experiments 81 patients with carcinomatous effusions were administered with MMC-CH (2.0-2.4 mg/kg in terms of MMC) in bolus intracavitarily. Fifty-one patients responded well to the MMC-CH therapy. Nineteen patients were alive for more than 6 months. The responders showed marked improvement in subjective symptoms, and 26 patients became dischargeable from hospital. Bone marrow suppression and peritoneal irritation were main adverse effects, but the symptoms were temporary and not so serious in spite of a high dose of MMC.

Charcoal↗
PubMed2002

[Combination chemotherapy with intra-perioneal infusion of CDDP and continuous intravenous infusion of 5-FU for peritoneal metastasis in gastric cancer--analysis of long-term survivors].

In order to evaluate the utility of combination chemotherapy with intra-peritoneal infusion of CDDP and continuous intravenous infusion of 5-FU, we performed this therapy in 23 primary gastric cancer patients with peritoneal metastasis. CDDP was administered intraperitoneally at a dose of 70 mg/m2 over 2 hours on day 1, and 5-FU was continuously administered intravenously at a dose of 700 mg/m2 for 5 consecutive days from day 1, respectively. This treatment was given twice. Median survival time with this treatment was 343 days, and the depth of invasion was selected as an independent prognostic factor according to multivariate analysis. Five patients (21.7%) have survived more than 3 years. Major toxicities were less than Grade 2 except for two patients with each anemia (Grade 3) and venous thrombosis (Grade 3), respectively. This regimen appears to be feasible and effective for gastric cancer patients with peritoneal metastases. Long term survival may be obtained in patients without adjacent organ invasion.

Adult↗
PubMed2002

[Repeated intraperitoneal injection of low-dose CDDP for gastric cancer with ascites owing to peritonitis carcinomatosa].

We attempted treating 5 patients with ascites from peritonitis carcinomatosa of gastric carcinoma using TS-1 as systemic chemotherapy, and repeated intraperitoneal injection of low-dose CDDP for the carcinomatous ascites. TS-1 was administered in the usual manner and repeated intraperitoneal injection of CDDP (10 mg/body) dissolved in physiological saline 20-500 ml was given with an implantable reservoir. In 3 patients, the carcinomatous ascites disappeared, and in 2 other patients they decreased remarkably. As a result, the QOL and PS of all patients were improved. Serum concentration of CDDP suggested that weekly repeated intraperitoneally injected CDDP not only has an effect on peritonitis carcinomatosa, but also functions as a modulator for 5-FU.

Aged↗
PubMed1992

[Intraperitoneal administration of cisplatin (CDDP) for advanced or recurrent gastric cancer with peritoneal dissemination].

This study was undertaken in order to evaluate the effect of intraperitoneal administration of CDDP on fourteen patients with peritoneal dissemination of advanced or recurrent gastric cancer. The procedure was used together specific hydration transfusion and diuretics. Two patients showed a complete response and 5 patients a partial response. Following this therapy, 2 patients have survived for more than 6 months. Alimentary symptoms (nausea, vomiting) were found but renal toxicity and serious myelosuppression were not recognized in all patients.

Adult↗
PubMed2004

[A case of effective weekly paclitaxel administration for primary lesion of schirrous gastric cancer].

We report a case of advanced schirrous gastric cancer with carcinomatous peritonitis. Chemotherapy with TS-1 was applied during the first 4 weeks, but the tumor did not respond to this therapy. Next, paclitaxel (TXL) was administered at a weekly dose of 90 mg/body/day for 3 weeks followed by a week interval of rest. Remarkable mass reduction of primary tumor was observed after 3 courses of treatment, and the symptom derived from primary tumor was relieved without significant side effects. The clinical course for schirrous gastric cancer with carcinomatous peritonitis is still miserable for patients, although many attempts have been made to improve its prognosis. A weekly paclitaxel regimen appears to be one of the promising treatment for schirrous gastric cancer.

Adenocarcinoma, Scirrhous↗
PubMed2004

[A case of advanced gastric cancer with peritonitis carcinomatosa resected with intraperitoneal chemotherapy based on chemosensitivity test with ascites].

The patient was a 57-year-old man who developed obstructive jaundice and pancreatitis. He was diagnosed with peritonitis carcinomatosa from gastric cancer, and the cancers were unresectable at first laparotomy. We gathered the accumulated ascites and examined the fluid by chemosensitivity test. Some anti-cancer drugs were selected based on the test results of test, and four cycles of modified PMUE therapy (CDDP ip, MMC iv, ETP po, UFT-E po) were performed. This chemotherapy proved very effective, and the cytodiagnostic malignancy with ascites changed from class V to II before and after chemotherapy. Following chemotherapy, a re-laparotomy was performed and a curability B operation could be undertaken. He survived for 17 months after the first laparotomy, but died of extra-peritoneal recurrence in the pelvic cavity. Treatment of advanced gastric cancers with peritonitis carcinomatosa is very difficult, because none of the various therapies (operation, chemotherapy, hyperthermia etc.) can completely control dissemination. It is very effective when the chemosensitivity of individual cancers is clear before chemotherapy. The current chemosensitivity test with ascites is still technically incomplete, but it may contribute to improved treatment of cancers with peritonitis carcinomatosa in the future.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2005

[A case report of bowel obstruction due to peritonitis carcinomatosa using combined administration with CPT-11 and CDDP].

We report here a case of recurrent gastric cancer that responded to third-line chemotherapy with CPT-11 and CDDP. The patient was a 61-year-old man with recurrent gastric cancer, who had administered TS-1 for first-line chemotherapy and paclitaxel for second-line chemotherapy. After such therapy, bowel obstruction was revealed due to peritoneal dissemination. The patient underwent third-line chemotherapy with CPT-11 and CDDP after drainage of gastrointestinal juice by nasogastric tube. The treatment schedule for CPT-11 and CDDP therapy consisted of CPT-11 60 mg/m2 div at day 1, day 15 and CDDP 60 mg/m2 div at day 1. It was repeated every 4 weeks. After first administration, the bowel obstruction was improved, so the treatment was continued for 8 months on an outpatient basis. These findings imply that this treatment can be a useful second-line or third-line chemotherapy for unresectable advanced or recurrent gastric cancer.

Ambulatory Care↗
PubMed1993

[Intraperitoneal repeated chemotherapy using CDDP combined with MMC for carcinomatous peritonitis].

Based on our experimental study, which indicated that simultaneous combined administration of MMC and CDDP prolonged life more significantly than individual administration, clinical application was performed on three cases of carcinomatous peritonitis from Borrmann type 4 cancer of the stomach. The dosage was 14 mg/m2 (7 mg/m2 at second and following administrations) of MMC and 35 mg/m2 of CDDP and they were repeatedly administered in the abdominal cavity via the drug delivery system. As the result, no severe toxicities were found except for two cases of leukopenia (Grade 2). Effectiveness was indicated in all cases with the negative change of cytology, whereas no improvements in prognosis were obtained. We concluded that some new devices would be necessary to increase the drug delivery to the carcinomatous wall.

Adenocarcinoma↗
PubMed1993

[Intraperitoneal administration of cis-diamminedichloroplatinum (II) for peritoneal carcinomatosis caused by gastric cancers].

The effectiveness of the intraperitoneal administration of cis-diamminedichloroplatinum (II) for peritoneal carcinomatosis by gastric cancers was evaluated through experimental and clinical studies. In experimental studies, the effect of sodium thiosulfate (STS) on cytotoxic activity of DDP was evaluated by MTT assay using human gastric cancer cell lines. The cytotoxic activity of DDP was reduced by 50% with 100-fold STS in the area under the curve (AUC), whereas 10-fold STS in AUC did not reduce the cytotoxicity of DDP. In clinical studies, patients were treated with one of three protocols: Group A was treated by the intraperitoneal injection (ip) of DDP at a dose of 70 mg/m2, and group B or C was treated by ip DDP at a dose of 110 mg/m2 with or without STS rescue. The pharmacodynamics and the adverse effects of treatments were evaluated between these three protocols. In group C, the means of AUC of STS were 2.43-, 10.8- and 86.8-fold those of total platinum in the peritoneal cavity, plasma, and urine, respectively. There were 1/5, 1/2 and 2/2 partial responses in peritoneal carcinomatosis patients treated with A, B and C. Renal toxicity was not observed in the patients treated with DDP and STS rescue. STS does not seem to reduce the antitumor activity of DDP in peritoneal cavity and plasma, while the renal cytotoxicity was reduced by STS rescue. The result led us to conclude that intraperitoneal DDP treatment combined with STS rescue would be useful chemotherapy against peritoneal carcinomatosis by gastric cancer.

Adult↗
PubMed2001

Calcifying fibrous pseudotumor of mesentery presenting with acute peritonitis: case report with immunohistochemical study and review of literature.

Calcifying fibrous pseudotumor (CFP) is a benign soft tissue lesion composed of thick collagen bundles, scattered fibroblasts, and psammomatous and dystrophic calcifications, located most commonly in the extremities and trunk of children and young adults. The present case in a 36-year-old woman is to the best of our knowledge the first report of a large CFP confined to the mesentery, which, because of torsion, led to acute peritonitis and emergency laparotomy. The typical histologic features were accompanied by a prominent myofibroblastic proliferation along with inflammatory response at the periphery of the lesion. The spindle cells of the lesion were positive for vimentin and focally for CD34 and smooth-muscle actin. Review of the literature and discussion of differential diagnosis in this report focuses on abdominal CFP and other intraabdominal soft tissue lesions, some of which may be precursors of CFP. Int J Surg Pathol 9(3):249-253, 2001

Acute Disease↗
PubMed2003

[Efficacy of TS-1 in patients with peritonitis carcinomatosa from gastric cancer].

Medical treatment with TS-1 was performed in patients with gastric cancer with peritonitis carcinomatosa. The median survival time for the patients who underwent distal or total gastrectomy was 14.0 months, and that for the patients who underwent exploratory laparotomy was 9.3 months. Compared with other medical care, the anti-cancer drug TS-1 enabled prolonged survival time and shortened hospitalization. Since TS-1 had few side effects, it was useful to patients suffering from gastric cancer with peritonitis carcinomatosa.

Adult↗
PubMed1997

[Evaluation of intraperitoneal chemotherapy using CDDP/MMC or CDDP for gastric carcinomatous peritonitis].

The prognosis of positive cytology case (cy (+)) without peritoneal dissemination (P0) and P (+) cases were poor. In this study, the efficacy of intraperitoneal chemotherapy (i.p. therapy) for these patients was evaluated in 26 gastric cancer patients. Intraperitoneal repeated administration of MMC 10 mg/body and CDDP 40-50 mg/body (15 cases) or CDDP 40-50 mg/body (11 cases) alone was performed once a month via the drug delivery system. Negative change of cytology was observed in 13 out of 19 patients, and the prognosis of these patients was better than that of the unchanged cytology group. The prognosis of P0/cy(+) was better than that of P(+) patients. Two year survival rate of P0/cy(+) with i.p. therapy was better than that of P0/cy(+) without i.p. therapy (58.3% vs 22.5%). Adverse drug reaction such as severe gastro-intestinal symptoms and bone marrow toxicities were not recognized. In conclusion, this report suggests that i.p. therapy is more useful for P0/cy(+) cases than that of P(+) cases in gastric cancer. Randomized controlled trials should be done to confirm the efficacy of the intraperitoneal chemotherapy regarding the prolongation of life.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

[A case of advanced type 4 gastric cancer with peritonitis dissemination, navel metastasis effectively treated with combined chemotherapy of biweekly paclitaxel (TXL) and TS-1].

The patient was a 44-year-old woman who had unresectable advanced gastric cancer with peritoneal dissemination and navel metastasis (Sister Mary Joseph metastasis). The lesion was considered surgically incurable, so she was placed on neoadjuvant chemotherapy consisting of biweekly TXL (100 mg/m2/day 1, 15) and TS-1 (80 mg/m2/day 1-14) and 2 weeks rest. Before chemotherapy, she could not eat anything because of poor expansion of the stomach and ascites. After the 1st course she could eat half the volume of a normal meal. The only side effect of this treatment was pigmentation of the skin and alopecia. After the 2nd course, she returned home and chemotherapy was continued on an outpatient basis. After the 5th course, the stenosis of colon and ascites had disappeared in a barium enema and CT scan, respectively. The poor expansion of the stomach was slightly improved. She was considered to have responded and underwent total gastrectomy with D2 and transverse colectomy and splenectomy. There were no clear nodules indicating peritoneal dissemination in the intra-operative findings. Intra-operative cytological examination was negative. The depth of the cancer invasion was limited to the subserosal layer and there was no invasion to the colon histologically. There was no lymph node metastasis, but there were a small number of cancer cells obtained diffusely in the omentum and mesocolon. There was no findings of recurrence 5 months later. Biweekly TXL and TS-1 therapy was thought to be an effective chemotherapy against advanced gastric cancer.

Adult↗
PubMed2004

[A case of scirrhous carcinoma of the stomach with malignant pleural and peritoneal carcinomatosis responding to the local administration of docetaxel (TXT)].

We report the case of a 34-year-old woman who underwent total gastrectomy for scirrhous carcinoma in the stomach (T4, N0, H0, CY1, P1, Stage IV). Despite adjuvant chemotherapy with TS-1 and/or CDDP, ascites caused by peritoneal carcinomatosis increased four months after gastrectomy. Therefore, intraperitoneal administration of docetaxel (TXT) at a dosage of 45 mg/m2 was applied. This therapy successfully maintained her good quality of life by inhibiting the increase of ascites without any severe adverse side effects for more than six months. When the left effusion from pleural carcinomatosis appeared nine months after the surgery, the intrathoracic administration of TXT succeeded in inhibiting the increase of pleural effusion over five months or more. In this case, intraperitoneal and intrapleural administrations of TXT were effective and temporarily improved the patient's quality of life without any side effects. We thought that the local administration of TXT was a useful treatment without severe toxicities for malignant pleural effusion and ascites in scirrhous carcinoma of the stomach.

Adenocarcinoma, Scirrhous↗