Infusional 5-fluorouracil and mitomycin C: an effective regimen in the treatment of advanced gastric cancer.
BACKGROUND
Weekly infusional 5-fluorouracil (5-FU) and folinic acid (FA) as part of multi-drug chemotherapy regimens in advanced gastric cancer (AGC) has shown to be effective with low toxicity. The present analysis was carried out to evaluate the safety and efficacy of 5-FU/FA in combination with 3-weekly mitomycin C (MMC) in patients with advanced gastric cancer.


METHODS
A total of 28 patients with AGC were analysed (first line n=23). They received weekly 24-h 5-FU 2,600 mg/m2 preceded by 2-h FA 500 mg/m2 for 6 weeks followed by a two week rest period. Bolus MMC 10 mg/m2 was applied on days 1 and 22. Patient characteristics were: m/f 17/11; median age 67 years (43-79). The most common metastatic sites were liver and peritoneum (n=12, respectively).


RESULTS
A median of 3 and a total of 91 cycles were administered. Mean dose intensity in cycle I was: 5-FU 86%, MMC 87%. Responses were observed in 43%, no change was seen in 29% of the patients. Median overall survival was 9.7 months (10.7 months for patients treated first line). Non-haematological toxicities (NCI CTC grades 3 and 4) were observed in 2 patients, leukopenia and thrombocytopenia grades 3/4 were observed in 50 and 25% of the patients, respectively.


CONCLUSIONS
Infusional 5-FU/FA plus MMC may safely be used in patients with AGC in the routine clinical setting. This regimen yields response rates and survival data comparable to platinum-based regimen.
Rudi
Jochen
J
Abteilung Innere Medizin I, Theresienkrankenhaus und St. Hedwig-Klinik GmbH, Mannheim, Germany.
Werle
Stefan
S
Bergtholdt
Doris
D
Hofheinz
Ralf-Dieter
RD
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007262:Infusions, Intravenous; D002955:Leucovorin / Q000008:administration & dosage*; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology*; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D016685:Mitomycin; D002955:Leucovorin; D005472:Fluorouracil