Oxaliplatin with Biweekly Low Dose Leucovorin and Bolus and Continuous Infusion of 5-fluorouracil (Modified FOLFOX 4) as a Salvage Therapy for Patients with Advanced Gastric Cancer.
- Author:
Sung Hwan SUH
1
;
Hyuk Chan KWON
;
Ji Hoon JO
;
Young Rak CHO
;
Bong Gun SEO
;
Dong Mee LEE
;
Sung Hyun KIM
;
Jae Seok KIM
;
Hyo Jin KIM
Author Information
1. Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea. kimhj@dau.ac.kr
- Publication Type:Original Article
- Keywords:
Stomach neoplasms;
Salvage chemotherapy;
Oxaliplatin;
5-fluorouracil
- MeSH:
Diarrhea;
Drug Therapy;
Fever;
Fluorouracil*;
Humans;
Leucovorin*;
Neutropenia;
Salvage Therapy*;
Stomach Neoplasms*;
Thrombocytopenia
- From:Cancer Research and Treatment
2005;37(5):279-283
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To determine the activity and the toxicity associated with a low dose regimen of leucovorin (LV) plus 5-fluorouracil (5-FU) combined with oxaliplatin every two weeks (modified FOLFOX 4) as a salvage therapy for advanced gastric cancer patients. MATERIALS AND METHODS: Between December 2003 and December 2004, 33 patients were enrolled in this study. The patients were treated with oxaliplatin 85 mg/m2 as a 2-hour infusion on the first day plus LV 20 mg/m2 over 10 minutes. Subsequently, the patients were given a 5-FU bolus 400 mg/m2 followed by a 22-hour continuous infusion of 600 mg/m2 on days 1~2. The treatment was repeated at 2 week intervals. RESULTS: The median age of the patients was 50 years (range: 31~74), 82% (27/33) had the Eastern Cooperative Oncology Group performance status was 0 and 1. Of the 30 patients who could be evaluated for their tumor response, 8 achieved a partial response, with an overall response rate of 26.7% (95% confidence interval (CI): 20.5~32.7%). Fifteen patients (50%) showed stable disease and 7 patients (23.3%) progressed during the course of treatment. The median time from the start of chemotherapy to progression was 3.5 months (95% CI: 2.6~4.4 months) and the median overall survival time was 7.9 months (95% CI: 5.9~9.9 months). The major grade 3/4 hematological toxicity encountered included neutropenia (45.4%) and thrombocytopenia (3.0%). Neutropenic fever occurred during only 2 of the 178 cycles. The most common non-hematological toxicity encountered was grade 1/2 nausea/vomiting, which occurred in 18.2% of patients, diarrhea in 12.1% and neuropathy in 15.2%. There were no treatment related deaths. CONCLUSIONS: The modified FOLFOX 4 regimen appears to be a safe and effective salvage therapy for advanced gastric cancer patients.
