title: MMAF for advanced gastric cancer.
abstract: 65 patients with metastatic gastric carcinoma were treated with a combination of methotrexate 1.5 g/m2 with 5-fluorouracil 1.5 g/m2 on day 1 and doxorubicin 30 mg/m2 with mitomycin 4 mg/m2 on day 14. Cycles of chemotherapy were repeated every 4 weeks. The overall response rate was 29% with 6% complete responses and 23% partial responses. Prognostic factors that individually affected response were Karnofsky performance (P less than 0.002), and site of the primary tumour (P less than 0.007). Multivariate analysis showed that only increasing Karnofsky performance (P = 0.01) and disease status (P less than 0.02) (patients with recurrent tumours responding better than patients with postoperative residual disease and those with inoperable disease) were important in predicting response to therapy. The overall median survival was 7 months. All 4 patients with a complete response are alive in remission at 13, 28, 48 and 52 months from the date of starting chemotherapy. Univariate analysis identified increasing Karnofsky performance (P less than 0.0001), response to chemotherapy (P less than 0.02) and higher serum albumin (P less than 0.03) as prognostic indicators for survival. Multivariate analysis, of pretreatment factors and day 14 full blood count showed that only Karnofsky performance (P less than 0.0001) and day 14 platelet count (P less than 0.03) were shown to predict survival, higher platelet values being associated with decreased survival.
authors.affiliation: CRC Department of Medical Oncology, Christie Hospital, Manchester, U.K.
authors.forename: H
authors.initials: H
authors.lastname: Anderson
authors.forename: J H
authors.initials: JH
authors.lastname: Scarffe
authors.forename: M
authors.initials: M
authors.lastname: Ranson
authors.forename: A G
authors.initials: AG
authors.lastname: Kamthan
authors.forename: M
authors.initials: M
authors.lastname: Dougal
authors.forename: S A
authors.initials: SA
authors.lastname: Russell
authors.forename: M J
authors.initials: MJ
authors.lastname: Wilkinson
authors.forename: D G
authors.initials: DG
authors.lastname: Ostick
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000328:Adult; D000368:Aged; D000505:Alopecia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D008937:Mitomycins / Q000008:administration & dosage; D011379:Prognosis; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality
chemical_list: D008937:Mitomycins; D004317:Doxorubicin; D005472:Fluorouracil; D008727:Methotrexate