OBJECTIVETo compare the efficacy and tolerability of the regimen FOLFOX [1eucovorin (LV), 5-fluorouracil (5-Fu) and oxaliplatin] and the regimen PLF (Paclitaxel, leucovorin and 5-Fu) for treatment of advanced gastric adenocarcinoma.

METHODSWe retrospectively studied the clinical data of 132 patients with stage IV gastric adenocarcinoma treated by FOLFOX (group A, n=60) or PLF (group B, n=72). The tumor response rate, toxicity, time to progress (TTP) and overall survival (OS) were compared between the two groups.

RESULTSA total of 544 cycles were administrated in these patients. The overall response rate was 35.0% with FOLFOX regimen and 41.7% with PLF regimen, showing no significant difference between them (P>0.05). The TTP was 6.13-/+1.26 (95%CI, 3.65-8.61) months in group A, and 5.92-/+0.49 (95%CI, 4.97-6.87) months in group B; the OS was 10.67-/+1.55 (95%CI, 7.63-13.71) months in group A, and 10.8-/+3.07 (95%CI, 4.78-16.82) months in group B. Neither TTP or OS showed significant differences between the two groups (P>0.05). Five patients in group A (8.33%) and 8 in group B (11.11%) had grade 3 and 4 leukopenia. The non-hematological toxicities were mostly mild, including nausea, vomiting, stomatitis, diarrhea and alopecia. The main adverse effects were grade 1 or 2 sensory neuritis in FOLFOX group, and alopecia in PLF group, without significant difference between the two groups (P<0.05).

CONCLUSIONBoth FOLFOX and PLF can serve as effective first-line treatment of stage IV gastric adenocarcinoma with good tolerance.