Polydatin  or dose reduction due to toxicity were not higher. Therefore, this treatment may be feasible even for patients with massive ascites if they have good performance status, sufficient oral intake, and adequate organ function. However, median treatment duration and PFS are quite short in patients with massive ascites compared with other patients; therefore, more effective treatments may be necessary to improve the poor prognosis. To date, several clinical trials have been conducted or are ongoing in patients with peritoneal metastasis. The JCOG 9603 trial showed the efficacy of 5-FU plus methotrexate in patients with AGC with ascites: a response rate in terms of ascites of 35.1% was noted.

The JCOG 0106 study was conducted to compare infused 5-FU versus 5-FU plus Luteolin methotrexate in patients with AGC and peritoneal metastasis, but it did not show a superiority of 5-FU plus methotrexate. Although the JCOG 0106 trial did not include patients with massive ascites and did not evaluate response in terms of ascites, improvement of oral intake was reported in 48% of patients who were unable to eat at the study outset; this finding suggests substantial efficacy of the 5-FU-based therapy in patients with AGC and peritoneal metastasis. In the SPIRITS trial, combination treatment with cisplatin (SP) showed favorable results compared with S-1 alone in the subset of patients with peritoneal metastasis .

Although patients with massive ascites were excluded and detailed information about  purchase Puerarin ascites is not available in It is important to note the limitations of the present study. First, it was a retrospective analysis in a single institution with patients that had sufficient oral intake and adequate organ function. None of the patients had symptoms or complications such as decreased oral intake or renal dysfunction due to hydronephrosis; the treatment regimen used in our study may not be feasible for such patients. Specifically, patients with peritoneal metastasis frequently have an inability to eat, making it impossible to use oral agents in such patients, and patients with renal dysfunction should not be given cisplatin. Therefore,in these types of patients, other treatments such as intravenous 5-FU or combination therapy with taxanes may be the preferred choice. Second, we included both SP and XP in this study, although most order Honokiol patients were treated with SP.

Direct comparison of S-1 and capecitabine as well as indirect comparisons of several randomized studies using SP and XP suggest that these two treatments have similar efficacies.Additionally, our retrospective analysis comparing these two treatment regimens showed that they have similar efficacies and safeties. S-1 was suggested to be more efficacious than 5-FU in patients with diffuse-type AGC or AGC associated with high dihydropyrimidine dehydrogenase (DPD), with diffusetype tumors being more commonly Genes associated with high DPD than intestinal-type tumors are Since diffusetype cases are commonly associated with peritoneal metastasis, S-1 may be preferable for the treatment of AGC in this setting. In contrast, several small analyses have suggested that capecitabine is effective at treating highthymidine .