HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Neoadjuvant therapy of high-risk gastric cancer: a phase II trial of preoperative FAMTX and postoperative intraperitoneal fluorouracil-cisplatin plus intravenous fluorouracil.

AbstractPURPOSE AND METHODS:
We identified patients with gastric cancer at high risk for recurrence before therapy using endoscopic ultrasonography (EUS). Neoadjuvant therapy using the fluorouracil, doxorubicin, and metrotrexate (FAMTX) regimen was given for three courses before planned laparotomy with the intention to perform curative resection. Postoperatively, intraperitoneal (IP) cisplatin and fluorouracil (FU) and intravenous (i.v.) FU were administered to patients undergoing resection.
RESULTS:
Fifty-six assessable patients were treated. Preoperative FAMTX therapy was tolerable, with the major toxicity being neutropenic fever. One treatment-related death was seen. Eighty-nine percent of patients underwent surgical exploration and 61% had potentially curative resections. There were two postoperative deaths. Comparison of pathologic tumor (pT) stage with EUS-predicted tumor stage showed apparent downstaging in 51% of patients. Postoperative IP chemotherapy was delivered to 75% of eligible patients. Toxicity was acceptable. There was no increase in operative morbidity or mortality compared with concurrent nonstudy patients undergoing a similar operative procedure and not receiving preoperative therapy. With a median follow-up time of 29 months, the median survival duration was 15.3 months. For patients who underwent potentially curative resections, the median survival duration was 31 months. Peritoneal failure was seen in 16% of patients.
CONCLUSION:
Chemotherapy with the FAMTX regimen is tolerable in patients with locally advanced gastric cancer, without an increase in operative morbidity or mortality. IP therapy can be successfully delivered to most resected patients. The intraabdominal failure pattern appears to be decreased compared with expected. This approach is an appropriate investigational arm to pursue in future studies.
AuthorsD Kelsen, M Karpeh, G Schwartz, H Gerdes, C Lightdale, J Botet, G Lauers, D Klimstra, Y Huang, L Saltz, V Quan, M Brennan
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 14 Issue 6 Pg. 1818-28 (Jun 1996) ISSN: 0732-183X [Print] United States
PMID8656250 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Doxorubicin
  • Cisplatin
  • Fluorouracil
  • Methotrexate
Topics
  • Adenocarcinoma (diagnostic imaging, drug therapy, mortality, surgery)
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects, therapeutic use)
  • Cisplatin (administration & dosage, adverse effects)
  • Combined Modality Therapy
  • Doxorubicin (administration & dosage, adverse effects)
  • Female
  • Fluorouracil (administration & dosage, adverse effects)
  • Humans
  • Infusions, Intravenous
  • Infusions, Parenteral
  • Male
  • Methotrexate (administration & dosage, adverse effects)
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Risk Factors
  • Stomach Neoplasms (diagnostic imaging, drug therapy, mortality, surgery)
  • Survival Rate
  • Ultrasonography

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: