[Palliative surgery combined with oxaliplatin-based chemotherapy in treatment of patients with advanced gastric cancer].
OBJECTIVE
Gastric cancer has the highest incidence rate and mortality rate among gastrointestinal malignancies. Twenty percent of the patients with dissectable gastric cancer cannot be cured simply by surgery due to local infiltration and distant metastasis. To evaluate the therapeutic effectiveness and safety of oxaliplatin combined with 5-fluorouracil and leucovorin on the patients with gastric carcinoma after palliative gastric resection, we analyzed all of the cases of gastric adenocarcinoma undergone palliative gastric resection in our Cancer Center in recent years.


METHODS
A total of 41 patients who underwent palliative gastric resection from Jan. 2000 to May 2004 in our Cancer Center were evaluated. Chemotherapy was given 8-18 days post-surgically with oxaliplatin (130 mg/m(2), intravenus infusion) on day 1, leukovorin (200 mg/m(2)) on day 1, 5-FU (500 mg/m(2), infusion) on day 1 followed by (5-FU 2600 mg/m(2), continuous infusion) for 48 h, the cycle was repeated every 4 weeks. Primary evaluation was performed after 3 cycles of chemotherapy. The chemotherapy was terminated in the patients without response to the treatment. In the patients with response to the treatment, the chemotherapy continued until 6-8 cycles for further analyses.


RESULTS
None of the patients died from surgery or chemotherapy. Complete response occurred in 2 cases, partial response occurred in 19 cases, stable disease in 8 cases, and progressive disease in 12 cases. The total response rate was 52.5%. The 1-year, 2-year, and 3-year survival rates were 71%, 43%, and 32%, respectively. The side effects included neuropathy, nausea, vomiting, and myelosuppression. No grade 3 or 4 myelosuppression was observed.


CONCLUSIONS
Palliative surgery in late stage gastric cancer followed by combination chemotherapy of oxaliplatin, 5-fluorouracil and leucovorin is a safe therapeutic modality with promising short-term effectiveness and mild side effects.
Chen
Ying-Bo
YB
Department of Abdominal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou,Guangdong,510060, P.R.China. c.yingbo@medmail.com.cn
Guan
Yuan-Xiang
YX
Zhan
You-Qing
YQ
Li
Wei
W
Sun
Xiao-Wei
XW
Li
Yuan-Fang
YF
Xu
Da-Zhi
DZ
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005743:Gastrectomy; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010166:Palliative Care; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D015996:Survival Rate
D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil