ackground : Patients with unresectable or advanced gastric cancer require palliative systemic chemotherapy. Recently, cisplatin has been reported to be an effective agent against gastric cancer.And in vitro synergism between 5-fluorouracil and
cisplatin was demonstrated in the L1210 leukemia model. Therefore we performed a phase trial to assess the response
rate and toxicity of the combination regimen with 5-fluorouracil infusion and cisplatin for
patients with advanced gastric cancer.
Method : Thirty-six patients with previous untreated gastric cancer and measurable
diseases were treated with a combination of 5-fluorouracil and cisplatin. The regimen
consisted of 5-fluorouracil, 1,000 mg/mE2/day, by a 12-hour continuous infusion on day 1 to
5 and cisplatin, 60 mg/mE2/day, iv bolus on day 1, and the treatments were repeated every 3
weeks.
Results :
1) Among 34 evaluable patients, 21 patients (62%) achieved partial responses, and the
median duration of response was 5.7 months.
2) The median survival of overall patients was 8.1 months. The median survival of the
responders was 9.3 months and that for nonresponders, 3.8 months.
3) Age, sex, gastrectomy, weight loss, histologic grade did not influenced prognosis.
Among the performance status, 0-1 groups were more responsive to the treatment and longer
survival time than 2-3 group (p<0.005).
4) Toxicites were common but well tolerated.
Conclusion : A combination chemotherapy of 5-fluorouracil and cisplatin in patients with
advanced gastric cancer seems to be effective and well tolerated.
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