Comparison of 5-fluorouracil with ftorafur in adjuvant chemotherapies with combined inductive and maintenance therapies for gastric cancer.

1984 ◽  
Vol 2 (12) ◽  
pp. 1366-1371 ◽  
Author(s):  
T Nakajima ◽  
T Takahashi ◽  
K Takagi ◽  
K Kuno ◽  
T Kajitani
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Oral Administration ◽  
Cytosine Arabinoside ◽  
Statistical Significance ◽  
Locally Advanced ◽  
Survival Rates ◽  
Curative Gastrectomy ◽  
The Difference ◽  
Locally Advanced Cancer

A group of 243 patients with gastric cancer was subjected to a prospective randomized trial of adjuvant chemotherapy after curative gastrectomy. One of the three arms (regimen A) is induction therapy with a three-drug combination of mitomycin C (MMC), 5-fluorouracil (5-FU), and cytosine arabinoside (ara-C) followed by intermittent oral administration of 5-FU for two years (MFC + F). In regimen B, 5-FU in regimen A is replaced by ftorafur, administered on the same schedule as regimen A (MF'C + F'). Regimen C is the control, in which patients are treated by surgery alone. Regimen A was proven effective for the suppression of relapse in the limited groups of moderately locally advanced cancer; five-year survival rates of the subset of stages I, II, and III were 72.1% with regimen A and 53.1% with regimen C (P less than .05). Regimen B yielded a better survival than the control, although the difference did not reach statistical significance. The results seem to favor 5-FU as adjuvant chemotherapy for gastric cancer.

Randomized trial of adjuvant chemotherapy with mitomycin plus ftorafur versus mitomycin alone in resected locally advanced gastric cancer.

1998 ◽  
Vol 16 (3) ◽  
pp. 1036-1039 ◽  
Author(s):  
J J Grau ◽  
J Estapé ◽  
J Fuster ◽  
X Filella ◽  
J Visa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Early Stage ◽  
Locally Advanced ◽  
Survival Rates ◽  
Group Versus ◽  
Node Negative ◽  
Treatment Groups ◽  
Locally Advanced Gastric Cancer

PURPOSE We performed a clinical trial to determine whether postoperative adjuvant chemotherapy with two drugs versus one drug could prolong survival. PATIENTS AND METHODS From 1985 to 1996, 85 patients with completely resected locally advanced gastric cancer were enrolled. The subjects were randomized into two treatment groups, as follows: mitomycin (MMC) 10 to 20 mg/m2 intravenously (i.v.) on day 1 every 6 weeks plus ftorafur (FT) 500 mg/m2/d for 36 consecutive days; or MMC alone, 10 to 20 mg/m2 i.v. every 6 weeks. All courses were repeated four times. RESULTS After a median follow-up duration of 62 months, the overall 5-year survival rates were 67% for the MMC-FT group versus 44% for the MMC group (P = .04). Subgroup analysis to compare survival curves using the method of Mantel-Cox showed survival rates significantly in favor of the MMC-FT group in the subsets of patients with node-negative disease (P = .01) and those whose disease was stage IB or II (P = .008). CONCLUSION Significantly better survival results were observed for MMC-FT versus MMC alone. Subset analysis suggest a strong benefit in patients with node-negative and early-stage resected gastric cancer.

scholarly journals THE ROLE OF ADJUVANT CHEMOTHERAPY IN THE TREATMENT OF LOCALLY ADVANCED GASTRIC CANCER

2021 ◽  
Vol 20 (1) ◽  
pp. 133-140
Author(s):  
A. A. Bobryshev ◽  
M. M. Davudov ◽  
M. N. Narimanov ◽  
S. B. Polycarpova ◽  
V. Y. Kirsanov ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Treatment Options ◽  
Locally Advanced ◽  
Survival Rates ◽  
Literary Analysis ◽  
Cochrane Library ◽  
International Studies ◽  
Locally Advanced Gastric Cancer

The purpose of the study was a systemic literature review on data regarding the efficacy, safety and prospects for the use of adjuvant chemotherapy for locally advanced gastric cancer.Material and Methods. The study contained a thorough literary analysis of the results of international studies on the use of preoperative and postoperative chemotherapy for locally advanced gastric cancer. Relevant sources were searched in Medlin and Cochrane Library databases, and publications from 2001 to 2019 were included. Of all the studies analyzed, 28 were used to write the systematic review.Results. The increase in survival rates was mainly achieved due to the use of a multimodal approach to the treatment of gastric cancer. The effectiveness of this approach, which combined surgery with chemotherapy or chemoradiotherapy, was proven in several large clinical studies. However, despite the large number of treatment options for locally advanced gastric cancer, there is still no single standard for the management of patients with this disease. One of the treatment options successfully practiced in a number of leading countries is the use of adjuvant chemo/chemoradiation therapy.Conclusion. Analysis of the literature data of the last 18 years has shown the high relevance of studies on adjuvant chemotherapy for gastric cancer and the need to continue further study of this problem.

Lack of influence of the antidopaminergic drug domperidone on basal and TRH-stimulated TSH-serum levels after oral administration

1982 ◽  
Vol 101 (4) ◽  
pp. 550-554 ◽  
Author(s):  
K. W. Wenzel ◽  
J. Döring
Keyword(s):  
Oral Administration ◽  
Thyroid Function ◽  
Oral Absorption ◽  
Statistical Significance ◽  
Oral Intake ◽  
Serum Levels ◽  
The Novel ◽  
Antiemetic Drug ◽  
First Pass ◽  
The Difference

Abstract. Since antidopaminergic drugs are known to elevate basal and TRH-stimulated TSH-serum levels and since this effect was also shown after iv administration of the novel dopamine antagonistic agent domperidone, it was investigated, whether this antiemetic drug could interfere after oral intake with the evaluation of thyroid function. Oral domperidone caused a marked TSH-enhancement of TRH-induced TSH increments in 6 out of 14 euthyroid subjects, with no statistical significance, however. The difference between oral and parenteral influence as well as inter-individual changes are probably due to the varying first pass effect of the drug after oral absorption.

scholarly journals Survival Based On The Pathologic Lymph Node Ratio For Local Advanced Gastric Cancer; Elderly Patients Versus Non Elderly Patients

2021 ◽  
Author(s):  
Omer Yalkin ◽  
Nidal Iflazoglu ◽  
Olgun Deniz ◽  
Mustafa Yener Uzunoglu ◽  
Ezgi Isil Turhan
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Elderly Patients ◽  
Advanced Gastric Cancer ◽  
Lymph Node Ratio ◽  
Locally Advanced ◽  
Survival Rates ◽  
The Elderly ◽  
Survival Difference ◽  
Node Ratio

Abstract Objective: The aim of this study was to clarify the prognostic value of the pathological lymph node ratio for elderly and non-elderly gastric cancer patients and to evaluate whether there is a difference in the survival of patients with the same LNR (Lymph Node Ratio).Materials and Methods: A total of 222 patients diagnosed with locally advanced gastric cancer and who underwent gastrectomy were included. The patients were divided into two groups according to age. Clinicopathological properties of the two groups were compared. Potential prognostic factors affecting survival were analyzed. Subsequently, the effect of lymphadenectomy and LNR on survival in both groups was evaluated. Results: Significant differences were detected in terms of the location of primary lesions, hemoglobin and albumin levels between elderly patients and non-elderly patients (p < .05). Overall survival (OS) was significantly worse in elderly patients (22 months vs. 67 months, p<0.001). The survival rates in elderly patients were significantly lower from those of non-elderly in the subgroup LNR Stage 2 (12.1% vs. 47.9 %, P = 0.004) and LNR Stage 3 classification (9.1% vs. 34.1%, P = 0.039). LNR was found to be significant for OS with a cut-off point of 0.18. Conclusion: A survival difference was found between the elderly and non-elderly patients with the same LNR. LNR was found to be an independent factor for survival especially in elderly patients. Survival was found to be further decreased in elderly patients compared to non-elderly patients with increasing LNR.

scholarly journals Adjuvant chemotherapy is an additional option for locally advanced gastric cancer after radical gastrectomy with D2 lymphadenectomy: a retrospective control study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei Chen ◽  
Chenghai Zhang ◽  
Zhendan Yao ◽  
Ming Cui ◽  
Jiadi Xing ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Radical Gastrectomy ◽  
D2 Lymphadenectomy ◽  
D2 Gastrectomy ◽  
Group A ◽  
Group B

Abstract Background This study compared the long-term efficacy of different durations of adjuvant chemotherapy for patients with gastric cancer after radical gastrectomy with D2 lymphadenectomy. Methods We retrospectively identified 428 patients with stage II–III gastric cancer who underwent D2 gastrectomy between 2009 and 2016. Patients were divided into four groups according to the duration of adjuvant chemotherapy, including 0 week (no adjuvant, group A), 20 to 24 weeks (completed 7–8 cycles every 3 weeks or 10–12 cycles every 2 weeks, group B), and 12 to18 weeks (completed 4–6 cycles every 3 weeks or 6–9 cycles every 2 weeks, group C), and less than 12 weeks (received up to 3 cycles every 3 weeks or 5 cycles every 2 weeks, group D). The chemotherapy regimens included XELOX, SOX, and FOLFOX. 5-year overall survival (OS) and disease-free survival (DFS) were analyzed. Results The 5-year OS rates for groups A, B, C, and D were 52.3, 73.7, 72.0, and 53.3%, respectively, and the 5-year DFS rates were 50.0, 68.0, 65.4, and 50.0%, respectively. OS and DFS were higher in group B than in groups A and D. Similarly, patients in group C were more likely to have higher OS and DFS than those in groups A and D. Meanwhile, there were no significant differences in OS and DFS between groups B and C. The multivariate analysis confirmed with high statistical significance the efficacy of complete courses of adjuvant chemotherapy, and, among them, the similar impact of 4–6/6–9 and 7–8/10–12 cycles, resulting in similar HRs vs Group A (0.52 and 0.42, respectively). Conclusions To reduce toxicity and maintain efficacy, XELOX or SOX chemotherapy regimens administered for 4–6 cycles every 3 weeks or FOLFOX regimen for 6–9 cycles every 2 weeks might be a favorable option for patients with stage II–III gastric cancer after D2 gastrectomy. Prospective multicenter clinical trials with adequate sample sizes are necessary to verify these findings.

The interaction between microsatellite instability high (MSI-high) gastric cancer and chemotherapy on survival.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 244-244
Author(s):  
Elvira Lise Vos ◽  
Steven Brad Maron ◽  
Robert Wallace Krell ◽  
Masaya Nakauchi ◽  
Megan Fiasconaro ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Neoadjuvant Chemotherapy ◽  
Microsatellite Instability ◽  
Locally Advanced ◽  
Multivariable Analysis ◽  
Tumor Stage ◽  
High Status ◽  
High Group ◽  
Locally Advanced Gastric Cancer

244 Background: Subgroup analysis of trials data suggested a favorable prognostic role for microsatellite instability high (MSI-high) status in resectable gastric cancer, but a lack of survival benefit from neoadjuvant/adjuvant chemotherapy; questioning current standard of care for MSI-high locally advanced gastric cancer. To help guide treatment decision making, we retrospectively studied the interaction between MSI status and chemotherapy on survival in a single institution. Methods: All clinically advanced (tumor stage 3-4 or positive lymph nodes) gastric cancer patients that underwent gastrectomy between 2000-2018 with MSI status available from immunohistochemistry (IHC, deficient mismatch repair protein expression (dMMR) vs proficient (pMMR)) or DNA next generation sequencing testing (NGS, MSI-high vs low/stable (MSS)) were included. Clinicopathological characteristics and overall survival (OS) was compared between patients with neoadjuvant/adjuvant chemotherapy and without, stratified for MSI status, by Kaplan-Meier and Cox regression analysis. Results: From a total of 1,844 clinically advanced patients with resection, MSI status was available in 559 as determined by IHC in 420, NGS in 88, and both in 51 with a concordance rate of 50/51 (98%). Tumors were dMMR/MSI-high in 84 (15%) and pMMR/MSS in 475 (85%). Patients with dMMR/MSI-high tumors were more often older, female, and had distal tumors with intestinal subtype. Neoadjuvant and/or adjuvant chemotherapy was administered in 53 (63%) in the dMMR/MSI-high group and 367 (77%) in the pMMR/MSS (p = 0.006). Median (interquartile range) time of follow-up was 32 (19-57) months. In the total cohort, OS after 3 years was 82% in the dMMR/MSI-high and 59% in pMMR/MSS (p < 0.001). In the patients with neoadjuvant/adjuvant chemotherapy only, the dMMR/MSI-high had improved OS (3-years OS: 80% vs 60%, p = 0.001), and after adjustment for age and clinical tumor stage in multivariable analysis, dMMR/MSI-high status was associated with improved OS (HR 0.38 95%CI 0.22-0.68). In the dMMR/MSI-high group only, 3-year OS was 80% with chemotherapy vs 86% without (p = 0.374), and chemotherapy was not associated with a difference in OS after multivariable analysis (HR 1.03 95%CI 0.40-2.66). In case of neoadjuvant chemotherapy, grade 1 pathological response ( > 90%) was observed in 1/41 (2.4%) of the dMMR/MSI-high tumors vs 43/278 (16%) of the pMMR/MSS tumors respectively (p = 0.026). Conclusions: The incidence of MSI-high tumors in our cohort of clinically locally advanced, resectable, gastric cancers was 15%. Patients with MSI-high tumors had worse pathological treatment response to neoadjuvant chemotherapy, but better OS, compared to microsatellite stable tumors. However, in patients with MSI-high tumors, OS was not altered by neoadjuvant/adjuvant chemotherapy. We recommend assessing MSI status in locally advanced gastric cancer.

Adjuvant chemotherapy after complete resection in non-small-cell lung cancer. West Japan Study Group for Lung Cancer Surgery.

1996 ◽  
Vol 14 (4) ◽  
pp. 1048-1054 ◽  
Author(s):  
H Wada ◽  
S Hitomi ◽  
T Teramatsu
Keyword(s):  
Lung Cancer ◽  
Body Weight ◽  
Adjuvant Chemotherapy ◽  
Oral Administration ◽  
Small Cell Lung Cancer ◽  
Survival Rates ◽  
Small Cell ◽  
Control Group ◽  
Small Cell Lung ◽  
Control Groups

PURPOSE We performed a study to determine whether postoperative mild chemotherapy to maintain the patient's quality of life (QOL) and immunoactivity could also prolong survival. SUBJECT AND METHODS From December 1985 to July 1988, 323 patients with completely resected primary non-small-cell lung cancer (stage I to III) were enrolled. The subjects were randomized into three treatment groups, as follows: cisplatin (CDDP) 50 mg/m2 body surface, vindesine (VDS) 2 to 3 mg/kg body weight for three courses, and 1-year oral administration of tegafur (FT) plus uracil (UFT) 400 mg/kg body weight (CVUft group, 115 patients); 1-year oral administration of UFT 400 mg/kg body weight (Uft group, 108 patients); or surgical treatment only (control group, 100 patients). RESULTS The overall 5-year survival rates were 60.6% for the CVUft group and 64.1% for the Uft group versus 49.0% for the control group. The results of statistical testing were P = .053 (log-rank test) and P = .044 (generalized Wilcoxon test) among the three groups, P = .083 (log-rank) and P = .074 (Wilcoxon) between the CVUft and the control groups, and P = .022 (log-rank) and P = .019 (Wilcoxon) between the Uft and the control groups, which indicates higher survival rates in the CVUft and the Uft groups compared with the control group. A multivariate statistical analysis on prognostic factors using Cox's proportional hazards model was performed with the following results: P = .037, hazards ratio = 0.64 with a 95% confidence interval (CI) of 0.42 to 0.97 (control v CVUft group); and P = .009, hazards ratio = 0.55 with a 95% CI of 0.36 to 0.86 (control v Uft group). CONCLUSION Significantly favorable results were obtained in the CVUft and Uft groups compared with surgery alone. These data showed significant prognostic advantages in the postoperative adjuvant chemotherapy groups.

Evaluation of the effectiveness of adjuvant chemotherapy for locally advanced gastric cancer in real clinical practice

Pharmateca ◽  
2020 ◽  
Vol 7_2020 ◽  
pp. 41-45
Author(s):  
N.P. Belyak Belyak ◽  
R.V. Orlova Orlova ◽  
S.I. Kutukova Kutukova ◽  
N.V. Zhukova Zhukova ◽  
S.A. Borozdina Borozdina ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Locally Advanced ◽  
Locally Advanced Gastric Cancer ◽  
Real Clinical Practice

Docetaxel plus FOLFOX4 compared with FOLFOX4 as adjuvant chemotherapy for gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 181-181
Author(s):  
Chun-Xia Du ◽  
Xiao-Yan Liu ◽  
Hong-Gang Zhang ◽  
Ai-Ping Zhou
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Survival Rates ◽  
Subtotal Gastrectomy ◽  
Disease Free Survival ◽  
Adjuvant Radiation ◽  
Ptnm Stage ◽  
Gastric Cancer Patients

181 Background: To compare the efficacy of docetaxel plus FOLFOX4 to FOLFOX4 as adjuvant chemotherapy for gastric cancer patients. Methods: 320 patients with stage IB-IV (M0) gastric cancer were enrolled into the retrospective study. All patients received a total or subtotal gastrectomy with at least D1 lymph nodes dissection. 193 patients received FOLFOX4 as adjuvant chemotherapy. 127 patients received biweekly docetaxel plus FOLFOX4 (DOF regimen) as adjuvant chemotherapy. Docetaxel was administered at 40 mg/m2 on day 1, followed by FOLFOX4 regimen. Both of the regimens were repeated every 2 weeks for a maximum of 12 cycles. Results: In comparison with patients in FOLFOX4 group, patients in DOF group were relatively younger (p=.001), with more advanced disease in pN stage (p=.035) and pTNM stage (p=.031), received more cycles of adjuvant chemotherapy (p=.004), and had a higher percentage of adjuvant radiation (p =.002). After adjustment of unbalanced variables as mentioned above, no statistical difference was observed between DOF group and FOLFOX4 group in terms of 3-year disease-free survival (54% vs 69%, p = 0.100, HR 1.362, 95% CI (0.943-1.967)) and 3-year overall survival(70% vs 72%, p = 0.810, HR 1.049, 95% CI (0.711-1.548)). Stratified analysis according to clinicopathologic characters showed that there were almost no statistical differences of 3-year overall survival rates between two groups, except the primary site (middle 1/3) (p =.025) and pTNM stage (IIb stage) (p =.035) in favor of FOLFOX4 group. The incidences of grade 3/4 adverse events were obviously higher in DOF group than in FOLFOX4 group,including decreased appetite (18.1% V 10.4%, P = 0.046), diarrhea (4.7% V 0%, p=0.004 ), hypersensitivity reactions to oxaliplatin (3.1% V 0%, p=0.024) and neutropenia (47.3% V 31.6%, p=0.004). Conclusions: Compared to FOLFOX4 regimen, adjuvant docetaxel plus FOLFOX4 did not show significant survival advantages in gastric cancer patients. However, a more serious toxicity profile was observed in docetaxel plus FOLFOX4 arm. Further studies are needed to decide whether triplet regimen is appropriate as adjuvant chemotherapy of gastric cancer.

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