Discussion
CRS, gastric cancer
METASTASIS, PERITONEAL DISSEMINATION, GASTRIC CANCER
GC with peritoneal dissemination has poor prognosis and the median overall survival has been reported to be 6–10 months.To our knowledge, this is the first report of the combination of intraperitoneal high‐dose paclitaxel with modified SOX in advanced gastric cancer with peritoneal metastasis. The 1‐year OS rate reached 81.6%, which is a little higher than that reported in previous studies.For further research, we performed subgroup analysis of basic characteristics. The results showed that sPCI was a good index for a favorable prognosis. The sPCI cut‐off value for favorable prognosis has not been unified. Previous studies which focused on intraperitoneal infusion used 10 or 20 as the cut‐off values.Nine patients underwent radical gastrectomy and all of them had less than 12 points of sPCI, which means that 36.0% (9/25) of patients whose sPCI scores were less than 12 points had the opportunity to undergo radical gastrectomy after treatment with this regimen. The median OS of the 9 patients could reach 33.4 months, which means that patients with sPCI ≤12 in synchronous peritoneal metastasis of gastric cancer might be recommended crowd for this regimen as conversion therapy. Over the past decades, cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) therapy has been developed, and its application in gastric cancer with peritoneal metastasis has also become more widespread.Since we increased the dose of paclitaxel to 80 mg/mThere are some limitations to our study. First, it was a single‐arm phase II study, which made it impossible to compare 80 mg/mIn conclusion, the combination of intraperitoneal high‐dose paclitaxel and modified SOX is a safe therapy for advanced GC with peritoneal metastasis. Patients with sPCI ≤12 in synchronous peritoneal metastasis of GC should be recommended as conversion chemotherapy for this regimen. Compared with previous studies, it is more convenient and possibly more effective in some patients, but further clinical trials are necessary for a larger group of patients.