Abstract
e14518 Background: A relationship between dietary folate intake and efficacy of fluorouracil (FU) is supported by preclinical data. We already reported that dietary folate intake and genetic polymorphisms of MTHFR (methylenetetrahydrofolate reductase) or TYMS (thymidylate synthase) are associated with better outcome of FU-based chemotherapy (Shitara K, Matsuo K, et al. 2010 ASCO GI). However there might be the possibility that other nutrition or life style may confound the results. Methods: We retrospectively analyzed the survival impact of nutrition intake (folate, total energy, carbohydrate, protein, fat, Na, K, Ca, Fe, carotene, retinoid, vitamin B1, B2, C, D, E, SFA, MUFA, PUFA, SDF, IDF, TDF, N3PUFA, N6PUFA, N3HUFA) by a food frequency questionnaire and other life style behavior (smoking, drinking, body mass index) in 187 patients with advanced gastric cancer who were treated with first-line FU-based chemotherapy. Results: Median overall survival was 11.8 months and median progression-free survival was 5.0 months. Patients with folate intake showed longer survival compared with low folate intake (13.1 vs. 9.4 months). In a multivariate Cox model, folate intake were significantly associated with better survival (HR 0.68; 95%CI; 0.49-0.94; p = 0.02). If we stratified patients by, treatment regimens (monotherapy vs. combination chemotherapy) or histologic subtype (diffuse vs. intestinal), folate intake was associated with better survival in both groups. Similar tendency was observed in progression-free survival (HR 0.71: 95% CI; 0.52-0.95; p = 0.024). No other nutritional factor or life style behavior was associated with clinical outcome. Conclusions: These findings indicated that folate intake have a substantial effect on clinical outcome of patients with advanced gastric cancer treated by FU-based chemotherapy. No significant financial relationships to disclose.
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