Intra-arterial chemotherapy given preoperatively in the management of carcinoma of the stomach.

Intra-arterial chemotherapy has been used preoperatively in treating patients with carcinoma of the stomach. The chemotherapy was given continuously for about one month with gastrectomy planned for three to four weeks after completion of chemotherapy. The agents used were 5-fluorouracil, Adriamycin (doxorubicin hydrochloride) and mitomycin C. The objective was to reduce the size and extent of the disease prior to subsequent surgical resection. Most of the patients had a partial response to the chemotherapy infusion. Two patients had an apparent complete response. For 16 patients who presented with the most advanced lesions, initially considered to be incurable, some palliation was achieved but long term results were not significantly changed. For 17 patients with locally invasive disease which would normally have been treated by gastrectomy alone, with an expectation of about 10 per cent five year survival time, long term results appear to have been significantly improved.