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Table 1.

Clinical studies in advanced gastric cancer

Regimen Reference Patient Case no. Target metastasis Effect Survival Side‐effect (grade 3 or 4)
FAM MacDonald et al. ( 29 ) Patients with measurable cancer  62 AM, H, N, bone PR:42% MST: 5.5 months responder: 12.5 months non‐responder: 3.5 months Bone marrow: 7/62
FAMTX Wils et al. ( 30 ) Advanced gastric cancer with or without measurable disease Randomized clinical trial: FAMTX versus FAM 105 PT, H, N, P PR:41% (FAM 9%) 1‐year survival: 41% 2 years survival 9% Survival was significantly better than FAM Nausea: 63% Mucositis: 51% Diarrhea: 20% Alopecia: 24%
EAP Wilke et al. ( 27 ) Advanced gastric cancer with or without measurable disease  34 PT, H, N, P PR + CR:64% MST 18 months 2 years survival 26% Bone marrow: 48%
XELOX Park et al. ( 61 ) Advanced gastric cancer with or without measurable disease  20 PT, H, N, P PR(11) + CR(2): 65% Median progression free survival: 7.5 months No grade 3 and 4
Gemcitabine + FOLFOX‐4 Correale et al. ( 67 ) Chemother Metastatic gastric cancer  36 H, N, P, ovary, lung PR(15) + CR(4): 53% Survival: 11 months Neuropenia: 3/36 Mucositis: 4/36 Bone marrow: 6.7%
Docetaxel + capecitabine Kim et al. ( 62 ) Untreated metastatic or recurrent gastric cancer  32 PT, H, N, P PR13 + CR(1): 44% MST: 8.4 month 1 years survival 0%
TS‐1 Osugi et al.( 64 ) Advanced gastric cancer with peritoneal dissemination  18 P Non‐evaluable MST: 211 days Control MST: 118 days Bone marrow: 1/18
TS‐1 Yonemura et al. ( 58 ) Advanced gastric cancer with positive cytology  35 Cy1/P0 Non‐evaluable 2 years survival 53% Control 2‐year survival 9% Grade 3 and 4: 0%
Paclitaxel + TS‐1 Kobayashi et al. ( 78 ) Advanced gastric cancer Standard gastrectomy of more than a D2 dissection 50 and CY0‐1 T3‐4, N0‐2, P0, H0 M0, Safe and feasible Non‐evaluable PTX: Neuropathy 1/50, leucopenia 1/50, neutropenia 4/50 S‐1: Diarrhea 1/50, neutropenia 3/50, anemia 1/50
Docetaxel + TS‐1 Yoshida et al. ( 57 ) Advanced, recurrent gastric cancer  48 H, N, P, remnant, stomach PR:56% MST: 14.3 months Median time tumor progression: 7.3 months Bone marrow: 58% Anorexia: 15%
HIPEC Yonemura et al. ( 40 ) Advanced, recurrent gastric cancer  83 P PR:39% (17/43) Complete resection1 and 5 years survival: 61%, 17% Incomplete resection: 1 and 5 years survival: 30%, 2% Bowel perforation: 3/83 Bone marrow: 2/83
EPIC Jeung et al. ( 39 ) Advanced gastric cancer with peritoneal dissemination Palliative gastrectomy  49 P Better than control group MST: 12 months Median progression free survival: 7 months Bone marrow: 17/49 Nause vomiting: 10/49
Peritonectomy + hyperthermic i.p. chemotherapy (cisplatin + mitomycin C) Yonemura et al. ( 45 ) Advanced gastric cancer with peritoneal dissemination Aggressive cytoreduction 107 P Non‐evaluable MST: 11.5 months 5 years survival: 6.7% Not described
NIPS Yonemura et al. ( 5 ) Advanced gastric cancer Preoperative chemotherapy Clinical phase I  51 P Cytology 75%, PR:45% MST: 18 months, Peritonectomy: 18 months Complete cytoreduction: 20.4 months Bone marrow: 16% Operative mortality: 4.5%

5‐FU, 5‐fluorouracil; AM, abdominal mass; CR, complete response; EAP, etoposide + doxorubicin + cisplatin; EPIC, early postoperative intraperitoneal chemotherapy (5‐FU + cisplatin); FAM, 5‐FU + doxorubicin + mitomycin C; FAMTX, 5‐FU + doxorubicin + methotrexate; FOLFOX‐4, oxaliplatin + folinic acid + infusional 5‐FU; H, liver metastasis; HIPEC, hyperthermic intraperitoneal perfusion chemotherapy mitomycin C + etoposide + cisplatin; MST, median survival time; N, lymph node metastasis; NIPS, neoadjuvant intraperitoneal–systemic chemotherapy (methotrexate+ 5‐FU, i.v./docetaxel +carboplatin, i.p.); P, peritoneal dissemination; PR, partial response; PT, primary tumor; XELOX, oxaliplatin + capecitabine.