Weekly infusional high-dose 5-fluorouracil and leucovorin and biweekly cisplatin: A convenient treatment option in advanced gastric cancer

Yulia Kundel, Ofer Purim, Arie Figer, Salomon M. Stemmer, Thomas Tichler, Jaqueline Sulkes, Aaron Sulkes, Baruch Brenner*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)CR190-CR195
JournalMedical Science Monitor
Volume14
Issue number4
StatePublished - Apr 2008

Keywords

  • 5-FU
  • Advanced gastric cancer
  • Cisplatin

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