Long-term outcome of continuous 5-fluorouracil/cisplatin-based chemotherapy followed by chemoradiation in patients with resected gastric cancer

Amir Sonnenblick, Yakir Rottenberg, Luna Kadouri, Marc Wygoda, Avraham Rivkind, Gilad W. Vainer, Tamar Peretz, Ayala Hubert

Research output: Contribution to journalArticlepeer-review

Abstract

Despite substantial developments in gastric cancer treatment, the majority of patients relapse after definitive surgery. We have previously described well-tolerated adjuvant regimen that includes a combination of bolus 5-fluorouracil, continuous 5-fluorouracil, and cisplatin followed by chemoradiation after 3 months of chemotherapy. The aim of this study was to evaluate long-term outcomes of patients treated with this regimen and to determine whether expressions of the excision repair cross-complementing (ERCC1) and thymidylate synthase (TS) predict clinical outcome in those patients. The study population consisted of 36 advanced gastric cancer patients. Patients were treated with six cycles of continuous 5-fluorouracil (600 mg/m2) for 24 h, push 5-fluorouracil (400 mg/m2), and leucoverin (LCV) (200 mg/m2) on day 1-2 every 2 weeks, cisplatin (60 mg/m2) on day 1 every 4 weeks followed by combined modality therapy using 45 Gy at 1.8 Gy per day concomitant with weekly bolus 5-fluorouracil (600 mg/m2) and LCV (50 mg). After median follow-up of 48.9 months, the median disease-free survival was 45 months and the overall survival was 66.4 months. Sixteen patients (44 %) were alive and disease-free. There was no significant correlation between ERCC1 expression and TS expression pattern and time to relapse (P = 0.302 and P = 0.707, respectively). In conclusion, long-term follow-up demonstrates that postoperative chemoradiation with combination of bolus 5-fluorouracil, continuous 5-fluorouracil, and cisplatin is a feasible approach.

Original languageEnglish
Pages (from-to)3035-3038
Number of pages4
JournalMedical Oncology
Volume29
Issue number5
DOIs
StatePublished - Dec 2012
Externally publishedYes

Keywords

  • Adjuvant chemotherapy
  • ERCC1
  • Gastric cancer
  • Thymidylate synthase

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