3246 Long-Term Survival in a Patient with Recurrent Gastric Cancer with Peritoneal Seeding Undergoing Chemotherapy and Mistletoe Extract Treatment

INTRODUCTION: Recurrent gastric cancer with peritoneal seeding is associated with poor overall survival. Mistletoe extract has been widely used for complementary cancer therapy such as pancreatic cancer, ovarian cancer, and melanoma which support the quality of life and prolong overall survival. However, the effect of treatment for recurrent gastric cancer remains controversial. CASE DESCRIPTION/METHODS: A 71-year-old man with advanced gastric cancer underwent radical total gastrectomy (stage IIIb, T4b N1 M0). Abdominopelvic computed tomography performed 7 months after surgery revealed the increased ascites with an enhanced peritoneal thickening. He was diagnosed with peritoneal seeding and received 2nd line chemotherapy (Irinotecan). However, he was refused the chemotherapy due to side effects after 1 cycle. He starts receiving alternative therapy with Viscum album extract (mistletoe) instead of chemotherapy. Malignant ascites had decreased gradually after mistletoe extract therapy. So we start 3rd line chemotherapy (docetaxel) with mistletoe extract. The patient achieved good health with complete response postoperative 32 months after combination treatment. The patient has survived for 51 months after surgery without disease progression. We report a case of recurrent gastric cancer with peritoneal seeding that was successfully treated by docetaxel monotherapy with long-term mistletoe extract treatment. DISCUSSION: Mistletoe extract contributed to the reduction of malignant ascites and improved quality of life during chemotherapy. This case suggests that the synergistic effect of mistletoe extract treatment could be expected when used together with chemotherapy for recurrent gastric cancer.