[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.