Gastric lymphomas: chemotherapy as a primary treatment.

Twenty-one of 65 patients with gastric lymphoma have been treated with combination chemotherapy; 17 patients had chemotherapy as primary treatment, and 4 had it for residual disease after incomplete surgical resection. Three of these patients were in stage III and 18 were in stage IV of the disease, according to the TNM Staging Classification. CHOP-Bleo or CHOP combination was given to 17 patients, and the COPP-Bleo regimen to three; the last one was treated with COP. Sixteen of the 18 stage IV patients entered into complete remission after 6 to 10 courses of CHOP or COPP-Bleo; there was one partial response and one failure. Six complete responders had a surgical restaging performed and none of them had gross evidence of residual disease; all of them had partial gastrectomy and in five cases there was no microscopical evidence of disease; in one of the resected stomachs, a focus of residual disease was discovered involving the submucosa but without compromise of the serosa. Fourteen (77.7%) of these patients are alive with no evidence of disease 1-10 (X = 3.8 years); one patient died with recurrent disease at 30 months; another patient died of other causes after 3 years; one patient is alive with disease at 18+ months. All the remaining 16 stage IV patients who were not given chemotherapy have died, median survival time being 5 months.(ABSTRACT TRUNCATED AT 250 WORDS)

[Combined chemotherapy with the FEM protocol in advanced gastric cancer]. / Quimioterapia combinada con el esquema FEM en cáncer gástrico avanzado.

Thirty one patients with diagnosis of Gastric Cancer were admitted in this study. Median age was 71 years (range 24-82). Twenty two were male. No one had previous chemotherapy. Functional capacity was 0-1 in 26/31 (60.6%). More common symptoms were: loss of weight 21/31 (75.1%) and abdominal pain in 13/31 (40.3%). Ten patients were Borrmann III and nine Borrmann IV. Twenty one had surgery: 12 palliative gastrectomy and 9 exploratory laparatomy. Twenty three cases were adenocarcinoma and 8 undifferentiated carcinoma. FEM regimen was administered (5 Fluoruracil 600 mg/m2/day 1 and 8, Epidoxorubicin 30 mg/m2/day 1 and Mitomycin 10 mg/m2/day 1). Ten of 24 patients (41.7%) achieved partial remission with a median survival of 10.5 months. Three patients achieved subjective response with a median survival of 6 months. Median survival for the non response was 3 months (range 2-7 months). Survival difference between responders and no responders was statistically significant. Survival among the adjuvent group was 5.7 months (range 2-16 months). One out of three patients survived without evidence of disease at the end of this study. Twenty three patients died and 5 were lost to follow up. Alopecia was the most common secondary effect in 74%, nausea and vomiting in 60% and leukopenia below 3000 x mm3 in 54%. Cardiotoxicity was not documented in any case.