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Adjuvant treatment with infusional 5-fluorouracil in high risk adenocarcinoma of the stomach or gastroesophageal junction.

AbstractPURPOSE:
In high risk gastric and gastroesophageal adenocarcinoma, adjuvant radiochemotherapy with 5-fluorouracil bolus became a standard adjuvant treatment, showing significant improvement in overall survival after surgery, although with substantial toxicity. We explored the efficacy and toxicity of a modified 5-fluorouracil continuous infusion scheme.
METHODS:
We conducted an observational retrospective study in our centre. Gastric/gastroesophageal junction adenocarcinoma patients were treated with a schedule consisting in four infusions of bolus 5-fluorouracil 400 mg/m(2) iv with leucovorin 200 mg/m(2) iv and 1200 mg/m(2) in 46-hour infusion of 5-fluorouracil (D'Gramont scheme), followed by concomitant radiochemotherapy (45 Gy in 25 fractions of 1.8 Gy) with 5-fluorouracil continuously infusion 225 mg/m(2)/day and four additional infusions of chemotherapy one month after complete radiochemotherapy.
RESULTS:
Between January 2007 and December 2013, 55 patients received a mean of 3.16 bi-weekly adjuvant infusions followed by 4.6 weeks of continuous treatment concurrent with radiotherapy and 3.72 bi-weekly infusions after radiotherapy treatment. During adjuvant treatment, grade III toxicity was mostly haematologic, while gastrointestinal and cutaneous toxicity was predominant during concurrent treatment. There were no grade IV- or treatment-related deaths during this study. Disease-free survival (DFS) was 79.2 months (56.3-102.1 months), and the 3-year survival rates were 52.7 %.
CONCLUSIONS:
This 5-fluorouracil infusional scheme has an excellent tolerability profile and favourable efficacy results.
AuthorsN Martínez-Lago, M Vieito-Villar, Y Vidal-Insua, M E Padin-Iruegas, F Vazquez-Rivera, S Candamio-Folgar, R Lopez-Lopez
JournalClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico (Clin Transl Oncol) Vol. 17 Issue 11 Pg. 856-61 (Nov 2015) ISSN: 1699-3055 [Electronic] Italy
PMID26133519 (Publication Type: Journal Article, Observational Study)
Chemical References
  • Antineoplastic Agents
  • Leucovorin
  • Fluorouracil
Topics
  • Adenocarcinoma (drug therapy, mortality)
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents (administration & dosage, adverse effects)
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Chemoradiotherapy (methods)
  • Chemotherapy, Adjuvant (adverse effects, methods)
  • Disease-Free Survival
  • Esophagogastric Junction (pathology)
  • Female
  • Fluorouracil (administration & dosage, adverse effects)
  • Humans
  • Infusions, Intravenous
  • Kaplan-Meier Estimate
  • Leucovorin (therapeutic use)
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stomach Neoplasms (drug therapy, mortality)

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