A case of advanced gastric cancer with peritoneal metastasis that responded to paclitaxel plus 5-FU therapy

We report a case in which paclitaxel (PTX) plus 5-FU therapy was remarkably effective for advanced gastric cancer with peritoneal metastasis. The patient was a 41-year-old woman who had type 4 gastric cancer with peritoneal metastasis. PTX plus 5-FU therapy was performed. The regimen included 600 mg/body/day of 5-FU by continuous iv administration from day 1 to 5 and consequent administration of PTX (90 mg/body) on days 8, 15 and 22 for 28 days repetitively. After 4 courses were completed, abdominal CT revealed that ascites had disappeared and the stomach wall had become thinner. Thus,we considered the patient had a partial response, and performed total gastrectomy. After the operation, PTX plus 5-FU therapy was used for 8 courses with the same regimen. No serious adverse event was observed,and the patient maintained good QOL throughout the treatment. No sign of progressive disease was seen for 12 months after the operation. However, 18 months after beginning the treatment, peritoneal metastasis became worse, and she died 19 months after treatment had begun. Considering the effectiveness and mild toxicity, PTX plus 5-FU therapy is thought to be useful for advanced gastric cancer.