Phlorizin  or by imaging data [computed tomography (CT) scan or barium enema] with relevant signs such as ascites, hydronephrosis, and intestinal stenosis;  no previous chemotherapy other than adjuvant chemotherapy, which was required to have been finished more than 6 months before enrollment. Written informed consent for chemotherapy was obtained from each patient prior to treatment initiation.In patients with measurable lesions, the tumor response was assessed objectively according to the guidelines of the Response Evaluation Criteria In Solid Tumors (RECIST, ver. 1.0), and the best overall response was recorded as the antitumor effect for that patient.

The objective response rate in these patients was presented as the percentage of patients with a complete response (CR) or partial response (PR). According to the Japanese  Hesperidin Classification of Gastric Carcinoma,the amount of ascites was assessed by a radiologist using CT. Response rate for ascites represented the percentage of patients with complete disappearance (CR) or a dramatic decrease in ascites (PR). Time to treatment failure (TTF) was measured from the date of initiation of chemotherapy to the date of the last administration of fluoropyrimidine or cisplatin. The PFS was measured from the date of chemotherapy to the date of progressive disease or death from any cause. The OS was estimated from the date of initiation of chemotherapy to the date of death or last follow-up visit.

Median PFS and median OS were estimated by the Kaplan–Meier method. Toxicities were  purchase Oleanolic Acid graded according to the National Cancer Institute’s Common Terminology Criteria for Adverse Events. Our primary interest was in comparing the clinical outcomes among patient groups that had different amounts of ascites. The amount of ascites was defined as follows: small; moderate; or massive. This definition of massive ascites was the same as that used in the JCOG 0106 study . The volume of ascites was also estimated by the fivepoint method, as previously reported. We divided patients into the following three groups:  patients without ascites;  patients with small or moderate ascites; and  patients with massive ascites. P values for testing differences in baseline order Hordenine characteristics and response rates of each ascites group were calculated for homogeneity using chi-square tests and for trends using Fisher’s exact test. The PFS and OS were compared among the ascites groups by the log-rank test; the hazard ratio (HR) was calculated by the Cox proportional hazards model, and presented as HRs and 95% confidence intervals.

The median numbers of times that cisplatin was administered within the ascites groups were as follows: 4 times in patients without ascites; 3 times in patients with small to moderate ascites; and 2 times in patients with massive ascites. The frequency of discontinuation due to toxicities and dose reduction was not higher in patients with massive ascites than in the other two groups In our analysis, PFS and OS were worse in patients with massive ascites than in patients without ascites or patients with small or Genes moderate ascites. Although the incidence of anorexia was higher in patients with massive ascites.