This is a phase I trial investigating the safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC) using paclitaxel combined with intravenous FOLFOX therapy for gastric cancer patients with peritoneal metastasis.

Inclusion Criteria:

• Pathologically diagnosed as gastric adenocarcinoma
• Imaging scans or diagnostic laparoscopic findings suggestive of peritoneal metastasis
• HER-2 negative tumor
• Laboratory tests adequate for chemotherapy (within 2 weeks of enrollment)
• Absolute Neutrophil Count: ≧ 1,500/mm³
• Hemoglobin level: ≧ 8.0g/dL
• Platelet Count: ≧ 10×104/mm³
• AST (GOT), ALT (GPT): ≦ 100U/L
• Total Bilirubin: ≦ 2.0mg/dL
• Creatinine Clearance (CCl): ≧ 50mL/min
• ECOG 0 - 2

Exclusion Criteria:

• Patients with other major medical disease or malignant tumors other than gastric cancer
• Contraindication to 5-FU, Oxaliplatin, Leukovorin or Paclitaxel
• Pregnant, breast-feeding women or with birth plan
• History of gastrointestinal surgery
• Patients refusing treatment