title: Impact of the availability of active cytotoxic agents on the survival of patients with advanced gastric cancer.
abstract: Several cytotoxic agents, including fluoropyrimidines, platinums, taxanes and irinotecan, are effective in the treatment of advanced gastric cancer (AGC). However, the effect of the availability of cytotoxic agents on survival has not yet been evaluated. Therefore, the present study assessed the impact of the availability of active cytotoxic agents on the survival of patients with AGC. The records of 216 patients with newly diagnosed AGC that were treated with palliative chemotherapy between March 2002 and November 2012 at Chungbuk National University Hospital were reviewed. For the present study, the patients were divided according to the availability of active cytotoxic agents over the course of treatment: Group 1 received fluoropyrimidine and platinum; group 2 received fluoropyrimidine, platinum and taxane or irinotecan; and group 3 received fluoropyrimidine, platinum, taxane and irinotecan. The median overall survival times for groups 1, 2 and 3 were 6.3, 9.9 and 14.3 months, respectively (P<0.0001). Multivariate analysis revealed that the Eastern Cooperative Oncology Group (ECOG) performance status and the availability of active cytotoxic agents were independent prognostic factors, as the hazard ratios for mortality were 3.25 for patients with an ECOG performance status of 2-3 [95% confidence interval (CI), 1.99-5.30; P<0.0001], 0.58 for patients in group 2 (95% CI, 0.42-0.80; P=0.0009), and 0.40 for patients in group 3 (95% CI, 0.28-0.58; P<0.0001). The present study reveals that the availability of active cytotoxic agents is associated with an improved survival time in patients with AGC.
authors.affiliation: Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, North Chungcheong 361-763, Republic of Korea.
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, North Chungcheong 361-763, Republic of Korea.
authors.forename: Hye Sook
authors.initials: HS
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, North Chungcheong 361-763, Republic of Korea.
authors.forename: Jihyun
authors.initials: J
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, North Chungcheong 361-763, Republic of Korea.
authors.forename: Joung-Ho
authors.initials: JH
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, North Chungcheong 361-763, Republic of Korea.
authors.forename: Soon Man
authors.initials: SM
authors.lastname: Yoon
authors.affiliation: Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, North Chungcheong 361-763, Republic of Korea.
authors.forename: Dae Hoon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Surgery, College of Medicine, Chungbuk National University, Cheongju, North Chungcheong 361-763, Republic of Korea.
authors.forename: Hyo Yung
authors.initials: HY
authors.lastname: Yun
authors.affiliation: Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, North Chungcheong 361-763, Republic of Korea.
authors.forename: Ki Hyeong
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, North Chungcheong 361-763, Republic of Korea.
authors.forename: Sei Jin
authors.initials: SJ
authors.lastname: Youn
authors.affiliation: Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, North Chungcheong 361-763, Republic of Korea.
authors.forename: Seung Taik
authors.initials: ST
authors.lastname: Kim
keywords: availability; cytotoxic agent; gastric cancer; survival