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[CDDP-ip PMUE therapy in gastric cancer cases with liver metastasis]
Y Hasegawa1, S Honnma, K Takanashi
1Dept. of Surgery, Honnma Hospital.
Abstract:
To reduce liver metastasis and prevent carcinomatous peritonitis, we employed CDDP-ip PMUE therapy in gastric cancer cases with liver metastasis exceeding P0H2S2. Therapy consisted of cis-diammine-dichloroplatinum-ip (CDDP-ip), mitomycin C (MMC), uracil and futraful (UFT) and etoposide. From January 1990 to March 1991, primary lesions were resected in 6 gastric cancer cases with liver metastasis exceeding H2. On the basis of therapy, subjects were classified into 2 groups and the therapeutic effects were compared between them. One group was composed of 3 patients who were placed on CDDP-ip PMUE therapy beginning the 14th day after gastrectomy. The other group was composed of 3 patients who received only UFT oral administration (300 mg/body). As a rule, the following was the CDDP-ip PMUE therapy schedule: CDDP intraperitoneal administration (75 mg/m2) and MMC intravenous injection (10 mg/body) on day 1; etoposide intravenous injection (30 mg/body) on days 2 to 6; and consecutive UFT oral administration (300 mg/body). One case showed MR in a metastatic liver lesion, but treatment proved ineffective in the other cases. Although the 2 patients in the CDDP-ip PMUE therapy group, surviving 315 and 216 days, respectively, died of primary disease and hepatic insufficiency due to an increase in metastatic liver lesions, the third patient has been in good condition for 175 days. This therapy was thought to have prolonged survival. The post-operative survival period in the group of patients receiving only UFT oral administration ranged from 36 to 243 days, with all patients dying of primary disease. The main adverse effects of this therapy (i.e., digestive symptoms, leukopenia, and thrombocytopenia) were slight and transient in all cases. Because the subjects studied were gastric cancer cases exceeding H2, the present investigation resulted in the increase of metastatic liver lesions, a problem to be studied in future.