Prognostic factor analysis in advanced gastric cancer patients treated with hydroxyurea, leucovorin, 5-fluorouracil, and cisplatin (HLFP regimen).
This study was performed to determine the prognostic factors of 102 nonresectable locally advanced or metastatic gastric cancer patients prospectively treated with a multimodulation of 5-fluorouracil (5FU), hydroxyurea, leucovorin, and cisplatin. Response rate in 85 patients with measurable disease was 62.4% (95% confidence interval 51.9% to 72.9%). A weight increase (5% or more) was observed in 47% of patients, performance status improved in 70.6%, and symptoms disappeared in 69%. Median times for progression-free survival and overall survival were eight and 11 months, respectively. Liver metastases, more than two involved sites, and increased carcinoembryonic antigen (CEA) were found to be univariate adverse prognostic factors for survival. In a multivariate analysis, only the presence of liver metastasis was found to be an independent prognostic factor. Response rate and survival in patients with gastric linitis or diffuse forms were in the same range as in patients with intestinal forms of gastric adenocarcinoma.
Louvet
Christophe
C
Service de Médecine Interne-Oncologie, Hôpital St-Antoine, 184 rue du fbg St-Antonie, 75012, Paris, France. christophe.louvet@sat.ap-hop-paris.fr
Carrat
Fabien
F
Mal
Frédéric
F
Mabro
May
M
Beerblock
Karine
K
Vaillant
Jean-Christophe
JC
Cady
Jean
J
André
Thierry
T
Gamelin
Erick
E
de Gramont
Aimery
A
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000505:Alopecia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D004341:Drug Evaluation; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage / Q000009:adverse effects; D017567:Karnofsky Performance Status; D007674:Kidney Diseases / Q000139:chemically induced; D002955:Leucovorin / Q000008:administration & dosage; D015993:Life Tables; D008113:Liver Neoplasms / Q000453:epidemiology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000139:chemically induced; D011379:Prognosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D016896:Treatment Outcome; D015430:Weight Gain
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil; D006918:Hydroxyurea