A Phase II Study of Conversion Surgery After IP Paclitaxel With XELOX Chemotherapy in AGC With Peritoneal Dissemination
Status:
Recruiting
Trial end date:
2021-12-30
Target enrollment:
Participant gender:
Summary
Advanced gastric cancer combined with peritoneal seeind has dismal prognosis with poor
response to systemic chemotherapy and with rapid aggravation of symptoms such as abdominal
pain, ileus, and poor nutritional intake. Intraperitoneal (IP) chemotherapy through IP port
or catheter has lower complication than HIPEC (hyperthermic intraperitoneal chemotherapy) and
can deliver higher dose of chemotherapy with less systemic toxicity. IP chemotherapy combined
with systemic chemotehrapy showed benefit in several clinical trials, despite lack of
statistical significance in phase 3 clinical trial. Proper dose/combination of
chemotherapeutic agents and indication of IP chemotherapy should be investigated through
prospective, large-scale clinical trials.
Conversion surgery after cytotoxic chemotherapy showed improved survival in retrospective
studies. Our hypothesis is that IP chemotherapy combined with systemic chemotherpay
(capecitabine + oxaliplatin) would improve success rate of conversion surgery with R0
resection. In the present study, the treatment regimen consists of intraperitoneal paclitaxel
combined with oxaliplatin and capecitabine (XELOX), and will be performed following surgery.