Introduction. Still there is no consensus on the choice of the most efficient
and the least toxic chemotherapy regimen in the treatment of advanced gastric
cancer. Nowadays few therapy protocols are available for treating this
disease. Objective. Study was conducted to compare the efficacy and toxicity
of FAM (flurouracil, doxorubicin, mitomycin C) with CDDP and FU/FA
(cisplatin, 5-fluorouracil, leucovorin) protocols in patients with locally
advanced and metastatic gastric cancer. Methods. This randomized study
involved a group of 50 patients with locally advanced or metastatic gastric
cancer, who had not previously undergone chemotherapy treatment. Progression
free survival, overall survival and drug toxicity were evaluated. For
statistical analysis chi-square test, Kaplan-Meier curve and the log rank
test were used. Results. The overall response rate was 20% in the group
treated with FAM and 24% in the group treated with CDDP, FU/FA (4% of
patients from each group had complete response), but without significant
statistical difference. Median survival was 10.9 months in the FAM group and
11.8 months in CDDP, FU/FA group, with no statistically significant
difference. Non-haematological and haematological toxicities of CDDP, FU/FA
were considerably less frequent than of FAM, and there was no treatment
related deaths in any of the groups. Conclusion. Both investigated regimens
demonstrated moderate efficacy. The study shows in favour of justified
application of both protocols, while in regard to toxicity CDDP and FU/FA can
be recommended as preferable treatment for locally advanced and metastatic
gastric cancer. New strategies should be considered for better efficacy in
the treatment of advanced gastric cancer. New strategies are necessary with
the goal to achieve a better therapeutic effect.
A phase II study of biweekly mitomycin C and irinotecan combination therapy in patients with fluoropyrimidine-resistant advanced gastric cancer: a report from the Gastrointestinal Oncology Group of the Japan Clinical Oncology Group (JCOG0109-DI Trial)
