Abstract
Background/Aims : The purpose of this study was to investigate the efficacy and safety of 'irinotecan, leucovorin, 5-fluorouracil (FOLFIRI)' combination chemotherapy as a second-line treatment after failure of 'Oxaliplatin-5-fluorouracil-Leucovorin (FOLFOX-4)' combination chemotherapy in patients with advanced gastric cancer. Methods : Fifty-two patients who were diagnosed as pathologically proven gastric cancer, surgically unresectable and received FOLFIRI combination chemotherapy after faiure of FOLFOX-4 combination chemotherapy between September 2005 and February 2012 were enrolled. This study was performed retrospectively on the basis of medical records. The administered dose of Oxaliplatin was 85mg/m2 for 2 hour and Leucovorin 200mg/m2 for 2 hour on day 1, 5-FU 400mg/m2 for bolus on day 1 to day 2, 5-FU 600mg/m2 for 23 hours on day 1 to day 2, every 2 weeks. The administered dose of Irinotecan was 160mg/m2 or 180mg/m2 for 2 hour and Leucovorin 200mg/m2 for 2 hour on day 1, 5-FU 400mg/m2 for bolus on day 1 to day 2, 5-FU 600mg/ m2 for 23 hours on day 1 to day 2, every 2 weeks. The response was assessed every 3 cycles. The toxicities were evaluated for every course of chemotherapy according to NCI toxicity criteria ver. 3.0. Results : The median age of the patients was 57 (range, 26-78) years. Median overall survival(OS) was 7.8 months (6.6-9.0 months), and the median time to progression(TTP) was 5months (2.3-7.7 months). All patients were assessable for response. There was no complete remission. 9(17%)patients achieved partial response, 30(57%) stable disease, and 13(25%) progressive disease. The overall response rate was 17%. During a total 345 cycles, anemia worse than NCI toxicity grade 3 occurred in 3%, leukopenia in 12%, neutropenia in 19%, and thrombocytopenia in 1%, respectively. Neutropenic fever was occurred in 2 cycle. Dose reduction due to side effect in 114 cycles(33%). There is no regimen change due to side effect. No death resulting from toxicity were observed. Patients with less organ involvement by metastasis, less than 34 U/ml of CA19-9 and good responsiveness to third cycle of second line chemotherapy were associated with longer OS and TTP. Conclusion : Combination chemotherapy with irinotecan, leucovorin, 5-fluorouracil has a modest efficacy with acceptable toxicities in patients with advanced gastric cancer as a second-line treatment after failure of FOLFOX-4.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
