title: Adjuvant bi-weekly combination of cisplatin, infusional 5-fluorouracil and folinic acid followed by concomitant chemoradiotherapy with infusional fluorouracil for high risk operated gastric and gastroesophageal junction adenocarcinoma.
abstract: OBJECTIVE
  Chemotherapy and radiotherapy are approved in clinical practice of adjuvant treatment of gastric carcinoma. In present study, we retrospectively evaluated the efficacy and tolerability of an adjuvant treatment protocol including bi-weekly cisplatin, infusional 5-fluorouracil (5-FU) and folinic acid followed by continuous 5-FU infusion during radiotherapy.
  
  
  METHODS
  Between May 2005 and Dec 2008, 65 curatively resected gastric and gastroesophageal junction adenocarcinoma patients (stage III in 38 and stage IV M0 in 27) received chemotherapy including 50 mg/m2 cisplatin, 200 mg/m2 iv folinic acid, 5-FU 400 mg/m2 iv bolus followed by 5-FU 1600 mg/m2 46h-continuous infusion (CFF) bi-weekly. After 4 cycles of CFF, concomitant 200 mg/m2/day continuous infusion 5-FU and 4500 cGy radiotherapy were administered for 5 weeks. After this chemoradiotherapy an additional 4 cycles of CFF were given.
  
  
  RESULTS
  The median follow-up was 15 (6-36) months. Fifty seven (87.7%) patients completed at least 90% of the planned treatment. Median disease free survival was 18 months (95% CI:13.9-22.0) and median overall survival was 19 months (95% CI:15.2-22.8). Common adverse events of all grades were nausea and vomiting (53.8%), leucopenia (42.6%), anemia (30.7%) and diarrhea (20%). The most common grade 3 and 4 toxicities were leucopenia (9.2%), anemia (7.6%), febrile neutropenia (6.1%) and diarrhea (4.6%).
  
  
  CONCLUSIONS
  Bi-weekly CFF chemotherapy followed by continuous 5-FU infusion during radiotherapy is an effective and tolerable regimen for locally advanced operated gastric and gastroesophageal junction adenocarcinoma.
authors.affiliation: Department of Medical Oncology, Ankara Numune Education and Research Hospital, Turkey. doganuncu@yahoo.com
authors.forename: Dogan
authors.initials: D
authors.lastname: Uncu
authors.forename: Nuriye Yildirim
authors.initials: NY
authors.lastname: Ozdemir
authors.forename: Sercan
authors.initials: S
authors.lastname: Aksoy
authors.forename: Huseyin
authors.initials: H
authors.lastname: Abali
authors.forename: Berna Cakmak
authors.initials: BC
authors.lastname: Oksuzoglu
authors.forename: Burçin
authors.initials: B
authors.lastname: Budakoglu
authors.forename: Ramazan
authors.initials: R
authors.lastname: Yildiz
authors.forename: Nalan
authors.initials: N
authors.lastname: Aslan
authors.forename: Nurullah
authors.initials: N
authors.lastname: Zengin
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004943:Esophagogastric Junction; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D009367:Neoplasm Staging; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil