Comparison of efficacy of different route of administration of chemotherapy on unresectable, advanced gastric cancer

Abstract

BackgroundThe aim of this study was to compare the efficacy of two neoadjuvant chemotherapies (FLEEOX and XELOX) with different routes of administration for unresectable gastric cancer.MethodsA total of 85 patients with unresectable gastric cancer hospitalized from January 2007 to December 2009 received neoadjuvant chemotherapy. The FLEEOX group (48 patients) received the FLEEOX regimen(fluorouracil, leucovorin, http://epirubicin, epotoside, and oxaliplatin), which combined arterial with venous administration for one or two cycles, while the XELOX group (37 patients) received XELOX (capecitabine plus oxaliplatin) via venous administration for two to four cycles. The clinical response and overall survival of the two groups were compared.ResultsIn the FLEEOX group, the clinical response rate (RR) of chemotherapy was 85.4% (41 of 48 patients) and the median survival time was 25 months. The 1-year and 2-year disease-free survival (DFS) rates were 85.4% and 45.8%, respectively. In the XELOX group, the clinical RR was 59.5% and the median survival time was 9 months, while the 1-year and 2-year survival rates were 35.2% and 8.3%, respectively. The clinical RR, the R0 resection rate, the median survival time, and the 1-year and 2-year DFS rates were significantly better (P < 0.05) in the FLEEOX group than in the XELOX group. In addition, there were no significant differences in the rates of toxic and adverse reactions or post-operative complications between the two groups.ConclusionsFor patients with a preoperative diagnosis of unresectable gastric cancer, the efficacy of the FLEEOX regimen, which combines arterial with venous administration, was better than that of the XELOX regimen, using venous administration only. This combination of arterial and venous administration could be useful for improving the efficacy of neoadjuvant chemotherapy for gastric cancer.

Comparison between better and poorly differentiated locally advanced gastric cancer in preoperative chemotherapy: a retrospective, comparative study at a single tertiary care institute

“…As preoperative chemotherapy, the XELOX (capecitabine plus oxaliplatin) regimen was used in this study [ 14 ], as follows: intravenous infusion of oxaliplatin 130 mg/m 2 over 2 hours on Day 1, followed by capecitabine 1,000 mg/m 2 orally twice daily for 2 weeks. This cycle was repeated once every 3 weeks, and the patients were given two cycles before evaluation of the chemotherapeutic effect.…”

“…Patients’ liver and kidney function, bone marrow hematopoiesis, gastrointestinal reactions, and related adverse events were closely monitored during the treatment. Toxic reactions were evaluated using the National Cancer Institute Common Toxicity Criteria (version 3.0) [ 14 ].…”

“…In locally advanced gastric cancer, the primary tumor is invaded through the submucosal layers of gastric tissues, with regional nodal involvement, and occupies most of the normal gastric cell lines [ 11 , 12 ]. Although the long-term effects remain controversial, preoperative chemotherapy for locally advanced gastric cancer has shown encouraging rates of pathologic complete response and R0 resection, with acceptable rates of acute and late toxicities [ 13 , 14 ]. However, no report was found on the factor of pathological differentiation in preoperative chemotherapy of locally advanced gastric cancer.…”

Combined intra-arterial and intravenous chemotherapy for unresectable, advanced gastric cancer has an improved curative effect compared with intravenous chemotherapy only

“…Interventional methods have developed from single perfusion chemotherapy to chemoembolization, and in order to further improve the curative effect, researchers have attempted to combine intravenous and intra-arterial administration. Zhang et al ( 12 ) used an arteriovenous combination of 5-fluorouracil, leucovorin, etoposide, oxaliplatin and epirubicin in patients with unresectable advanced gastric cancer, and Nakajima et al ( 13 ) used neo-adjuvant chemotherapy for inoperable gastric cancer via local and general delivery routes. These studies demonstrated that combined treatment significantly improves the local and systemic effects of treatment in patients with advanced gastric cancer.…”

Gastric transcatheter chemoembolization can resolve advanced gastric cancer presenting with obstruction

“…Lipiodol transcatheter chemoembolization has been very successful in liver tumors, and the size of tumors decreased obviously after chemoembolization [10][11][12] . However, only transcatheter chemotherapy for gastric cancer has been reported 13 , chemoembolization has never been mentioned in the previous literature. In this study, we will review gastric transcatheter chemoembolization (GTC) in treating advanced gastric cancer with obstruction and evaluate its safety and effectiveness.…”