Abstracts
1998 Digestive Disease Week

#3585

PRE-OPERATIVE SUPERSELECTIVE INTRA-ARTERIAL CHEMO-THERAPY FOR THE TREATMENT OF UNRESECTABLE GASTRIC CARCINOMA. Igor B. Shchepotin1,2, Vyatcheslav Chorny2, Ludmila Gooluck2, Stephen R.T. Evans1. 1Department of Surgery, George Washington University, Washington ,D.C., 20037, 2Ukrainian Institute of Oncology and Radiology, Kiev, Ukraine.

From February 1988 to April 1994, 75 consecutive patients with unresectable gastric carcinoma were included in this prospective randomized study. Patients were randomized as follows: 26 patients received exploration or palliative surgery alone (S), 24 received pre-operative systemic intravenous chemotherapy and surgery (IVCH+S) and 25 received pre-operative superselective intra-arterial chemotherapy and surgery (IACH+S). In patients whose tumors were located on the lesser curvature, the left gastric artery was catheterized. In all other cases, the right gastroepiploic artery was catheterized. 5-Fluorouracil (5-FU) and doxorubicin (DR) were selected as the chemotherapeutic agents for both IVCH and IACH. Dosages were determined using a actual body surface area (BSA) calculation and a standard height and weight nomogram. The drug infusion was administered in two cycles with a 6 day interval approximately two weeks prior to surgery. The intravenous regimen was given at the same dosage and timing as the intra-arterial regimen. The median survival time after S and IVCH+S was only 91 and 96 days, respectively, as compared to 401 days in patients receiving IACH+S. The results confirmed that IACT + S conferred a highly significant survival advantage compared to S or to IVCH+S, adjusted for all patient characteristics (p > 0.0001).

Copyright 1996 - 1998, SSAT, Inc. Revised 29 June 1998.