Clinical study of drug accumulation in gastric cancer after preoperative intra-arterial EAP II injection therapy

Preoperative intra-arterial injection therapy using etoposide, epirubicin and carboplatin (EAP II) was done for patients with resectable advanced gastric cancer. Twenty-six patients (14 males and 12 females) were treated. The concentrations of adriamycin (ADM) and platinum (Pt) were measured in cancer tissue, normal mucosa and regional lymph-nodes which were obtained operatively and in sera just before operation. But the concentration of etoposide was not measured, because when we used preoperative intra-arterial injection therapy using etoposide, epirubicin and cisplatin (EAP I), the mean concentration of etoposide was less than the detectable limit in all tissues and in sera. There were no significant differences among the mean concentrations of ADM in all tissues and in sera. And the mean concentration of ADM in cancer tissue was not higher than that of intra-arterial EAP I injection therapy. The mean concentration of platinum in sera was significantly lower than in cancer tissues, normal mucosa and lymph-nodes. And the mean concentrations of platinum in cancer tissues and lymph-nodes were higher than those of intra-arterial CDDP or EAP I injection therapy. It was concluded that preoperative intra-arterial EAP II injection therapy may be an effective method to improve the usefulness of preoperative intra-arterial injection therapy for gastric cancer.