Polychemotherapy of Gastric Carcinoma

Wilke, H.; Preusser, P.; Achterrath, W.; Schmoll, Hans‐Joachim; Fink, U.; Poliwoda, H.

doi:10.1007/978-1-4612-3636-8_10

Cited by 1 publication

(5 citation statements)

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“…However, there were still 10-20% of patients developing grade 3 and 4 hematological and nonhematological toxicities [5,18]. Compared with ELF, our data suggested that HDFL is even less toxic.…”

Section: Discussionmentioning

confidence: 75%

“…Old age, poor performance status, and poor nutritional status are adverse prognostic factors for cancer chemo therapy [3,5,7]. Patients with these characteristics were often associated with severe chemotherapy-related toxici ty.…”

Section: Discussionmentioning

confidence: 99%

“…For example, ELF [5], originally designed for the older or cardiopathie patients, had a response rate of 32-53% in advanced gastric cancers. However, there were still 10-20% of patients developing grade 3 and 4 hematological and nonhematological toxicities [5,18].…”

Section: Discussionmentioning

confidence: 99%

“…Regimens involving cisplatin, doxorubicin, or etoposide have recently been developed to improve the re sponse rate of advanced gastric cancer [5][6][7][8], However, these regimens did not appear to provide longer overall survival or better palliation of the patients as compared with single-drug chemotherapy [9][10][11], A major concern has been the relatively severe treatment-related toxicity [9][10][11]. There has been a need for regimens with lower toxicity.…”

Section: Discussionmentioning

confidence: 99%

“…More than two thirds of these patients present with advanced stages of disease, for which surgery plays only a limited role. The 5-year survival rate is less than 15%, with a median sur vival of approximately 8 months after curative resection of stage III or localized stage IV tumors [2,3], Gastric cancer is moderately sensitive to cytotoxic treatments [4,5], Combination chemotherapy regimens with response rates around 40-70% have been reported [6][7][8][9][10][11]. However, these regimens were inevitably associat ed with a significant treatment-related toxicity, which jeopardized their value as palliative treatments.…”

Section: Introductionmentioning

confidence: 99%

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Weekly 24-Hour Infusion of High-Dose 5-Fluorouracil and Leucovorin in the Treatment of Advanced Gastric Cancers

et al. 1997

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Systemic chemotherapy for advanced gastric cancer is frequently associated with significant treatment-related toxicity, which is particularly severe in patients presenting with a poor general condition. A search for effective and low-toxic regimens for this group of patients is mandatory. A weekly 24-hour infusion of high-dose 5-fluorouracil (5-FU) and leucovorin (HDFL) has previously been demonstrated to be an effective treatment for advanced colorectal cancer with minimal toxicity. In the past 3 years, this regimen has been tested at our institutes in patients with advanced gastric cancer, the general condition of whom had made the use of intensive combination chemotherapy impossible. The regimen consisted of a weekly 24-hour infusion of 2,600 mg/ m² of 5-FU and 300 mg/m² of leucovorin. From August 1992 to December 1995, 34 patients had been treated with this regimen for a total of 488 courses (average: 14.4 per patient). Hematological toxicity of this regimen was minimal, with grade 3 or 4 leukopenia developing in only 1 (2.9%) patient. Other nonhematological toxicities were also negligible except a reversible neurotoxicity which developed in 2 patients. Twenty-five patients were eligible for response analysis. One complete response, 11 partial responses, 5 stable diseases, and 8 progressive diseases were observed. The response rate was 48% (32-72%, 95% CI). The median overall survival (OS) of the whole group was 7 months (range: 1-18+). The median OS and time to progression of the responders were 8.5 months (range: 2-18) and 5 months (range: 2-10+), respectively. The palliative effect was satisfactory with the Karnofsky performance status of the responders improving from a median of 50% (range: 20-90%) to 70% (range: 50-100%). Our retrospective data suggested that HDFL is an effective and low-toxic palliative treatment even in patients with a very poor general condition. We advocated that this regimen should be further tested in ordinary patients with advanced gastric cancer.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%