Safety of intraperitoneal administration of paclitaxel after gastrectomy with en-bloc D2 Lymph node dissection
Article first published online: 11 AUG 2011
Copyright © 2011 Wiley Periodicals, Inc.
Journal of Surgical Oncology
Volume 105, Issue 1, pages 43–47, 1 January 2012
How to Cite
Imano, M., Imamoto, H., Itoh, T., Satou, T., Peng, Y.-F., Yasuda, A., Kato, H., Shiraishi, O., Shinkai, M., Yasuda, T., Takeyama, Y., Okuno, K. and Shiozaki, H. (2012), Safety of intraperitoneal administration of paclitaxel after gastrectomy with en-bloc D2 Lymph node dissection. J. Surg. Oncol., 105: 43–47. doi: 10.1002/jso.22065
- Issue published online: 6 DEC 2011
- Article first published online: 11 AUG 2011
- Manuscript Accepted: 20 JUL 2011
- Manuscript Received: 5 APR 2011
- peritoneal carcinomatosis;
- positive cytological findings in peritoneal washings;
The aim of this study was to examine the safety, pharmacokinetics, and cytological efficacy against free intraperitoneal cancer cells of intraperitoneal chemotherapy (IPC) with paclitaxel after gastrectomy with en-bloc D2 lymph node dissection (GD2) in cases of gastric cancer with peritoneal carcinomatosis (PC) and/or positive cytological findings in peritoneal washings (CFPW).
Twenty-one patients with gastric cancer with PC and/or positive CFPW who underwent GD2 were treated with early, post-operative, intraperitoneal paclitaxel. Intra-chemotherapeutic toxicity and operative complication were measured using the common toxicity criteria of the National Cancer Institute, version 3.0. Intraperitoneal and plasma paclitaxel concentrations were measured using a high-performance liquid chromatography assay.
Grade 3 anemia occurred in two patients (9.5%) and neutropenia was observed in three patients (14.3%). No grade 4 toxicity was observed. A grade 2 operative complication was a superficial surgical site infection (4.8%) that was treated with antibiotics. Cytologically, no viable cancer cells were observed in the intra-abdominal fluid 24 hr after intraperitoneal administration of paclitaxel. The intraperitoneal/plasma area under the drug concentration–time curve (AUC) ratio was 596.9:1.
IPC with paclitaxel after GD2 is a safe and cytologically effective treatment modality for free intraperitoneal cancer cells. However, additional data are required to determine the effect on survival. J. Surg. Oncol. 2012; 105:43–47. © 2011 Wiley Periodicals, Inc.