ABSTRACT
Purpose:To compare with the efficacy in the immediate effects and toxicities on patients with advanced gastric cancer treated with 5-fluorouracil (5-FU) and leucovorin (LV) combined with oxaliplatin or paclitaxel. Methods:Forty patients with advanced gastric cancer, whose metastases to organs or sites included liver, lymphy node, abdominal cavity, abdominal wall, etc, were enrolled in this study, and was randomly divided into two groups (A and B groups). The A group of 20 patients (70% of them were retreated patients) were treated with a combination of oxaliplatin, leucovorin(LV) and 5-fluorouracil(5-FU) continuous infusion regimen. The B group of 20 patients (55% of them were retreated patients) were treated with a combination of paclitaxel, leucovorin (LV) and 5-fluorouracil(5-FU) continuous infusion regimen. Results:Of the 40 evaluable patients, there were two complete responses and seven partial responses (response rate 45%) in the A group, and nine partial responses (response rate 45%) in the B group. All patients were evaluable for toxicities. The most common toxicities were bone marrow depression,peripheral neuropathy,digestive tract toxicities and liver function damage in the A group. The most common toxicities were bone marrow depression and liver function damage in the B group. Conclusions:These two regimens (5-fluorouracil and lcucovorin combined with oxaliplatin or paclitaxel) showed good efficacy and acceptable toxicities in advanced gastric cancer patients, and the 5-fluorouracil and leucovorin combined with oxaliplatin regimen may have some virtues, such as economics, convenience of medication and less serious toxicities.[
ABSTRACT
Purpose: To evaluate the efficacy and toxicity of combination chemotherapy with paclitaxel and oxaliplatin (two new drugs) in patients with locally advanced and(or) metastatic gastric adenocarcinoma ( M/AGC). Methods: Between May 2001 and May 2002, 30 patients (22 male and 8 female) with a median age of 58 years (range35-80) were consecutively enrolled in this study. Oxaliplatin and paclitaxel were administered as a two-hour infusion every one or two weeks, respectively, and DDP or FUDR were infused in abdominal cavity every one week. Results: Thirty patients were evaluable for activity, with 2 complete and 17 partial responses, objective response rate( RR): 63% ( 95% CI: 46% -80%). Twenty-three of thirty patients (77%) experienced WHO grade Ⅰ-Ⅳ bone marrow suppression, which was the most common and serious toxicity. WHO Grade Ⅰ-Ⅲ side effect ( non-hematological toxicity) of gastrointestinal tract, liver, peripheral neuropathy, kidney , mucositis and heart occurred in 40%, 30%, 13%, 10%, 10% and 7% of patients, respectively. No patients withdrew because of treatment-related toxicity. Conclusions: Our data suggest that the combination of paclitaxel and oxaliplatin has promising therapeutic activity in patients with advanced gastric cancer. This regimen shows good efficacy and an acceptable safety profile in M/AGC patients, and may prove to be a suitable alternative regimen in this indication, especially for the patients with bad function of the heart , liver and kidney or old, physically weak patients.