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KMID : 0360319930250060837
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Journal of Korean Cancer Research Association
1993 Volume.25 No. 6 p.837 ~ p.847
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Retrospective Study on Therapeutic Effects of Etoposide, Adriamycin, and Cisplatin(EAP) Versus 5-Flurouracil, Adriamycin, and Mitomycin C(FAM) Combination Chemotherapy in Unresectable Gastric Cancer
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김석윤
최동욱/이종인/백남선/문난모/김용규
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Abstract
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There has been an initial widespread enthusiasm for EAP combination chemotherapy regimen in advanced gastric cancer, based on an uncontrolled phase II study, which showed higher response rate and ability to convert unresectable cases to
resectable
cases. But following studies couldn't duplicate the same results. On the other hand, FAM combination chemotherapy has been considered as standard chemotherapy in advanced gastric cancer conventionally.
The authors evaluated previously untreated 98 patients with unresectable gastric cancer which was confirmed by laparotomy, of whom 52 patients were treated with a FAM regimen from Jan. 1987 to Dec. 1988, and 46 patients were treated with a EAP
regimen
from Jan. 1990 to Dec. 1991 at Department of Surgery, Korea Cancer Center Hospital. The drug dosage and treatment schedules were identical to those of the original investigators. The only patients with measurable disease were evaluated for
response
rate.
Results were as following: Of the 47 measurable lesions, the overall response rates were 27% and 32% in FAM and EAP arm. We had no complete response in the both arms. The median duration of response and survival were 6 months vs 8 months and 9
months vs
8 months, respectively in the FAM and EAP arm(P>0.1). Patients with well or moderately differentiated carcinoma and/or locally advanced gastric cancer showed a higher response rate and a longer (p<0.05). EAP regimen caused significantly more
severe
leukopenia and thrombocytopenia than FAM regimen(p<0.05). Moreover, we had four(11%) treatment-related deaths in the EAP arm, due to profound sepsis during periods of severe myelosuppression. Severe nonhematologic toxicities were presented more
frequently in the EAP arm(p<0.05).
In conclusion, the EAP regimen for advanced gastric cancer was highly toxic and resulted in no better response rates and survival times than the FAM regimen. Our data don't support the use of EAP as standard chemotherapy for unresectable advanced
gastric cancer.
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KEYWORD
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