title: Adjuvant treatment with infusional 5-fluorouracil in high risk adenocarcinoma of the stomach or gastroesophageal junction.
abstract: OBJECTIVE
  In high risk gastric and gastroesophageal adenocarcinoma, adjuvant radiochemotherapy with 5-fluorouracil bolus became a standard adjuvant treatment, showing significant improvement in overall survival after surgery, although with substantial toxicity. We explored the efficacy and toxicity of a modified 5-fluorouracil continuous infusion scheme.
  
  
  METHODS
  We conducted an observational retrospective study in our centre. Gastric/gastroesophageal junction adenocarcinoma patients were treated with a schedule consisting in four infusions of bolus 5-fluorouracil 400 mg/m(2) iv with leucovorin 200 mg/m(2) iv and 1200 mg/m(2) in 46-hour infusion of 5-fluorouracil (D'Gramont scheme), followed by concomitant radiochemotherapy (45 Gy in 25 fractions of 1.8 Gy) with 5-fluorouracil continuously infusion 225 mg/m(2)/day and four additional infusions of chemotherapy one month after complete radiochemotherapy.
  
  
  RESULTS
  Between January 2007 and December 2013, 55 patients received a mean of 3.16 bi-weekly adjuvant infusions followed by 4.6 weeks of continuous treatment concurrent with radiotherapy and 3.72 bi-weekly infusions after radiotherapy treatment. During adjuvant treatment, grade III toxicity was mostly haematologic, while gastrointestinal and cutaneous toxicity was predominant during concurrent treatment. There were no grade IV- or treatment-related deaths during this study. Disease-free survival (DFS) was 79.2 months (56.3-102.1 months), and the 3-year survival rates were 52.7 %.
  
  
  CONCLUSIONS
  This 5-fluorouracil infusional scheme has an excellent tolerability profile and favourable efficacy results.
authors.affiliation: Medical Oncology Department, Hospital Clínico Universitario, Santiago de Compostela, Travesía de a Choupana S/N Santiago de Compostela, 15706, La Coruña, Spain. nievesmartinezlago@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Martínez-Lago
authors.affiliation: Medical Oncology Department, Hospital Clínico Universitario, Santiago de Compostela, Travesía de a Choupana S/N Santiago de Compostela, 15706, La Coruña, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Vieito-Villar
authors.affiliation: Medical Oncology Department, Hospital Clínico Universitario, Santiago de Compostela, Travesía de a Choupana S/N Santiago de Compostela, 15706, La Coruña, Spain.
authors.forename: Y
authors.initials: Y
authors.lastname: Vidal-Insua
authors.affiliation: Department of Functional Biology and Health Sciences, Human Anatomy and Embryology Section, University of Vigo, Vigo, Pontevedra, Spain.
authors.forename: M E
authors.initials: ME
authors.lastname: Padin-Iruegas
authors.affiliation: Medical Oncology Department, Hospital Clínico Universitario, Santiago de Compostela, Travesía de a Choupana S/N Santiago de Compostela, 15706, La Coruña, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Vazquez-Rivera
authors.affiliation: Medical Oncology Department, Hospital Clínico Universitario, Santiago de Compostela, Travesía de a Choupana S/N Santiago de Compostela, 15706, La Coruña, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Candamio-Folgar
authors.affiliation: Medical Oncology Department, Hospital Clínico Universitario, Santiago de Compostela, Travesía de a Choupana S/N Santiago de Compostela, 15706, La Coruña, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Lopez-Lopez
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D059248:Chemoradiotherapy / Q000379:methods; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D004943:Esophagogastric Junction / Q000473:pathology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D053208:Kaplan-Meier Estimate; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality
chemical_list: D000970:Antineoplastic Agents; D002955:Leucovorin; D005472:Fluorouracil
keywords: 5-Fluorouracil infusional; Gastric cancer; Toxicity