Docetaxel plus 5-fluorouracil for terminal gastric cancer patients with peritoneal dissemination

Abstract

Background/aims: There are few reports on chemotherapy for poor prognosis terminal patients with peritoneal dissemination of gastric cancer, especially in those with renal dysfunction, because of the possibility of severe toxicity. We conducted a study of the combination of docetaxel and 5-fluorouracil for the treatment of these patients to improve quality of life because of its low toxicity.

Methodology: Five patients were treated in this study. All patients had a large volume of carcinomatous fluid in the abdomen, without liver or distant metastasis. The respective doses of docetaxel and 5-fluorouracil were 60 mg/m2 on day 1 and 370 mg/m2 on days 1 to 5 by intravenous infusion. Patients received this treatment 2-7 times every 2-3 weeks.

Results: Grade III/IV toxicity occurred, consisting of neutropenia (100%) and diarrhea (40%). No patients developed renal dysfunction. Carcinomatous fluid volume diminished for 15-96 days. Quality of life questionnaire score and performance status scale was significantly improved from 75-86 to 51-61 (p = 0.041) and 3-4 to 0-1 (p = 0.039), respectively. All patients were able to leave hospital after this treatment. Four of five patients died and median survival time was 223 days. Two of five patients achieved partial response and three patients showed no response (response rate 40%).

Conclusions: This new combination therapy had benefit for terminal patients with peritoneal dissemination of gastric cancer.