TY - JOUR
T1 - Weekly infusional high-dose 5-fluorouracil and leucovorin and biweekly cisplatin
T2 - A convenient treatment option in advanced gastric cancer
AU - Kundel, Yulia
AU - Purim, Ofer
AU - Figer, Arie
AU - Stemmer, Salomon M.
AU - Tichler, Thomas
AU - Sulkes, Jaqueline
AU - Sulkes, Aaron
AU - Brenner, Baruch
PY - 2008/4
Y1 - 2008/4
N2 - Background: To summarize our experience using a regimen of weekly 5-FU and leucovorin (LV) and biweekly cisplatin (CDDP) in advanced gastric cancer (AGC). Material/Methods: Patients had previously untreated histologically confirmed AGC. Treatment consisted of intravenous weekly infusional 5-FU and LV and biweekly CDDP, given for 6 weeks followed by a 2-week rest. Initially, a lower dose level was used (5-FU 2000 mg/m2, LV 500 mg/m2, CDDP 40 mg/m2), which was later increased (5-FU 2600 mg/m2, LV 500 mg/m2, CDDP 50 mg/m2). Results: Forty-five patients were treated, 18 at the lower dose level and 27 at the higher dose level. The median age was 67 years and 55% were male. Grade ≥3 toxicity was documented in 37% of patients but toxicity related hospitalizations or treatment discontinuation occurred in only 22% and 13%, respectively. There were no toxic deaths. The most common hematological toxicities were anemia and neutropenia and the most common non-hematological toxicities were nausea, vomiting and fatigue. Of the 39 patients evaluable for response, 13 (33%) had partial response (PR) and 11 (28%) had stable disease (SD). Control of disease (PR+SD) was achieved in 61%. The higher dose level was associated with a higher response rate (p=0.07) and an increased toxicity (p=0.01), mostly hematological and gastrointestinal. Median progression-free survival and overall survival were 3.5 and 9.2 months, respectively. Conclusions: This regimen appears safe, with a manageable toxicity profile. Efficacy data resemble those reported for more complex and toxic regimens. The higher dose level had enhanced activity, at the expense of increased toxicity.
AB - Background: To summarize our experience using a regimen of weekly 5-FU and leucovorin (LV) and biweekly cisplatin (CDDP) in advanced gastric cancer (AGC). Material/Methods: Patients had previously untreated histologically confirmed AGC. Treatment consisted of intravenous weekly infusional 5-FU and LV and biweekly CDDP, given for 6 weeks followed by a 2-week rest. Initially, a lower dose level was used (5-FU 2000 mg/m2, LV 500 mg/m2, CDDP 40 mg/m2), which was later increased (5-FU 2600 mg/m2, LV 500 mg/m2, CDDP 50 mg/m2). Results: Forty-five patients were treated, 18 at the lower dose level and 27 at the higher dose level. The median age was 67 years and 55% were male. Grade ≥3 toxicity was documented in 37% of patients but toxicity related hospitalizations or treatment discontinuation occurred in only 22% and 13%, respectively. There were no toxic deaths. The most common hematological toxicities were anemia and neutropenia and the most common non-hematological toxicities were nausea, vomiting and fatigue. Of the 39 patients evaluable for response, 13 (33%) had partial response (PR) and 11 (28%) had stable disease (SD). Control of disease (PR+SD) was achieved in 61%. The higher dose level was associated with a higher response rate (p=0.07) and an increased toxicity (p=0.01), mostly hematological and gastrointestinal. Median progression-free survival and overall survival were 3.5 and 9.2 months, respectively. Conclusions: This regimen appears safe, with a manageable toxicity profile. Efficacy data resemble those reported for more complex and toxic regimens. The higher dose level had enhanced activity, at the expense of increased toxicity.
KW - 5-FU
KW - Advanced gastric cancer
KW - Cisplatin
UR - http://www.scopus.com/inward/record.url?scp=42149128259&partnerID=8YFLogxK
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AN - SCOPUS:42149128259
SN - 1234-1010
VL - 14
SP - CR190-CR195
JO - Medical Science Monitor
JF - Medical Science Monitor
IS - 4
ER -