Bimonthly Regimen of High-Dose Leucovorin, Infusional 5-Fluorouracil, Epirubicin and Cisplatin (Modified ECF) as Adjuvant Chemotherapy in Resected Gastric Adenocarcinoma

Abstract

<b><i>Background:</i></b> The administration of the de Gramont regimen in combination with cisplatin and epirubicin (modified ECF) has previously been reported as a treatment for advanced gastric cancer, but here we report this regimen combination in an adjuvant setting for the first time. <b><i>Methods:</i></b> Forty-eight patients with curatively resected gastric cancer were treated. Each 2-week cycle consisted of epirubicin (50 mg/m<sup>2</sup>), cisplatin (50 mg/m<sup>2</sup>), 5-fluorouracil (5-FU) IV bolus (400 mg/m<sup>2</sup>) and 5-FU IV (2,400 mg/m<sup>2</sup>) over 46 h plus leucovorin IV (400 mg/m<sup>2</sup>) over 2 h. Postoperative chemoradiotherapy was also administered to the patients when indicated. We retrospectively reviewed the patients who were treated with modified ECF. <b><i>Results:</i></b> The median disease-free survival (DFS) was 40.7 months and the 1-, 3- and 5-year DFS rates were 78.5, 55.7 and 44.6%, respectively. The most common grade 3–4 toxicities were hematological and gastrointestinal. <b><i>Conclusion:</i></b> A modified ECF regimen may be an effective and convenient treatment with tolerable toxicities for the adjuvant treatment of gastric cancer. It may provide an alternative regimen to the standard ECF when a continuous ambulatory infusion pump is not feasible or not preferred by the patient.

Schedule-Dependent Effects of Kappa-Selenocarrageenan in Combination with Epirubicin on Hepatocellular Carcinoma

“…Comparative and noncomparative clinical trials have demonstrated that regimens containing conventional doses of epirubicin achieved equivalent even higher objective response rates and overall median survival as similar doxorubicin-containing regimens in the treatment of advanced and early breast cancer, non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), nonHodgkin's lymphoma, ovarian cancer, gastric cancer and nonresectable primary hepatocellular carcinoma (Nair et al, 1998;Khasraw et al, 2012). Recently, dose-intensive regimens of epirubicin have achieved high response rates in a number of malignancies including early and advanced breast cancer and lung cancer (Unek et al, 2012;Vici et al, 2012). However, improved overall survival has not yet been demonstrated.…”