Objective To explore the efficacy of albumin-bound paclitaxel (Abraxane) combined with tegafur (S-1) in the treatment of peritoneal metastasis of gastric cancer.

Methods Clinical data of 18 gastric cancer patients with peritoneal metastasis admitted to Zhongshan Hospital, Fudan University and Xuhui District Central Hospital of Shanghai from September 2018 to December 2019 and treated by AS (Abraxane plus S-1) regimen were retrospectively analyzed, and 10 patients with middle-large ascites were treated by abdominocentesis and intraperitoneal injection only once. All patients were treated with AS (Abraxane plus S-1) regimen during their first-line treatment. Abraxane (125 mg/m², d1 and d8) and S-1 (80 mg/m², bid, d1-14) were administered every 3 weeks. If no disease progression occurred after 6 cycles of chemotherapy, Abraxane and S-1 would be administered alternately as a subsequent maintenance treatment. CT evaluation and regular follow-up were conducted every 3 months.

Results Totally, 10 males and 8 females were enrolled with a median age of 58.5 years. The median progression-free survival (PFS) time and overall survival (OS) time was (10.00±2.51) months and (14.00±0.85) months, respectively. Meanwhile, the overall response rate (ORR) and disease control rate (DCR) of these patients was 44.44% and 77.78%, respectively. There were 10 patients with peritoneal metastasis and malignant ascites. The median PFS of patients with or without ascites was (7.00±1.46) months and (11.00±1.28) months, respectively (P=0.43). The main adverse events were hand-foot syndrome, alopecia, diarrhea, and neutropenia.

Conclusion AS regimen exhibited promising efficacy and well tolerance in first-line treatment of gastric cancer patients with peritoneal metastasis. Precise treatment against specific target might prolong survival time.