Linitis plastica medical therapy

The mainstay therapy for linitis plastica is surgical. However, in the case of linitis plastica adjuvant or neoadjuvant therapy is preferred concomitantly with surgery or prior to surgery to avoid future morbidities.

Pharmacologic medical therapy is recommended among patients with linitis plastica who are at higher risk for metastasis.

• FLOT regimen is recommended as neoadjuvant therapy in those with linitis plastica, since it has proven higher survival rates.^[1][2][3]
• The FLOT regimen is associated with a higher response rate (16 percent versus 8 percent), and has less toxicity which generally makes it more favorable.

• 1 Stage 1 – FLOT regimen
  • 1.1 Stomach
    • 1.1.1 Adult
      • Preferred regimen (1):Docetaxel 50 mg/m² every 2 weeks for 4 cycles preoperative and post-operative
      • Preferred regimen (2):Leucovorin 200 mg/m² every 2 weeks for 4 cycles preoperative and post-operative
      • Preferred regimen (3): Oxaliplatin85 mg/m² every 2 weeks for 4 cycles preoperative and post-operative
      • Preferred regimen (4): Fluorouracil 2600 mg/m² every 2 weeks for 4 cycles preoperative and post-operative
      • Alternative regimen (1): FLOT regimen with Epirubicin 50 mg/m² every 2 weeks for 3 cycles preoperative and post-operative on day 1
      • Alternative regimen (2): FLOT regimen with Cisplatin 60 mg/m² every 2 weeks for 3 cycles preoperative and post-operative on day 1