PURPOSE: Neoadjuvant chemotherapy in locally advanced gastric cancer is effective, but is often associated with severe side effects, including fatal outcome. This study evaluates a combination of cisplatin, folinic acid and 5-fluorouracil (PLF) in terms of efficacy (R-0 resection rate) and toxicity. METHODS: Twenty-five patients with locally advanced gastric cancer who after extensive staging were deemed not suitable for curative resection underwent neoadjuvant chemotherapy. Three or four cycles of cisplatin (50 mg/m(2) days 1 and 15), folinic acid (200 mg/m(2) days 1, 8, 15 and 22), and 5-fluorouracil (2,000 mg/m(2 ) days 1, 8, 15 and 22) were administered. Cases with progressive disease were taken off the study. Two weeks after finishing chemotherapy resection was performed and all patients were enrolled in a structured follow-up. RESULTS: Of the patients, 22/25 finished chemotherapy and 20 of those underwent laparotomy. In 13/25 patients (52%) a R-0 resection and in three cases a R-1 resection were achieved. Four patients stayed irresectable. During 76 completed cycles of chemotherapy we observed five cases of WHO grade-III toxicity and no grade-IV toxicity. CONCLUSIONS: The presented PLF protocol yields R-0 resection rates comparable to protocols like EAP (etoposide, adriamycin, platinum), but with a better safety profile allowing administration in an outpatient setting. Our study supports PLF as a reference neoadjuvant treatment for gastric cancer even outside of clinical studies.
PURPOSE: Neoadjuvant chemotherapy in locally advanced gastric cancer is effective, but is often associated with severe side effects, including fatal outcome. This study evaluates a combination of cisplatin, folinic acid and 5-fluorouracil (PLF) in terms of efficacy (R-0 resection rate) and toxicity. METHODS: Twenty-five patients with locally advanced gastric cancer who after extensive staging were deemed not suitable for curative resection underwent neoadjuvant chemotherapy. Three or four cycles of cisplatin (50 mg/m(2) days 1 and 15), folinic acid (200 mg/m(2) days 1, 8, 15 and 22), and 5-fluorouracil (2,000 mg/m(2 ) days 1, 8, 15 and 22) were administered. Cases with progressive disease were taken off the study. Two weeks after finishing chemotherapy resection was performed and all patients were enrolled in a structured follow-up. RESULTS: Of the patients, 22/25 finished chemotherapy and 20 of those underwent laparotomy. In 13/25 patients (52%) a R-0 resection and in three cases a R-1 resection were achieved. Four patients stayed irresectable. During 76 completed cycles of chemotherapy we observed five cases of WHO grade-III toxicity and no grade-IV toxicity. CONCLUSIONS: The presented PLF protocol yields R-0 resection rates comparable to protocols like EAP (etoposide, adriamycin, platinum), but with a better safety profile allowing administration in an outpatient setting. Our study supports PLF as a reference neoadjuvant treatment for gastric cancer even outside of clinical studies.
Authors: U Vanhoefer; P Rougier; H Wilke; M P Ducreux; A J Lacave; E Van Cutsem; M Planker; J G Santos; P Piedbois; B Paillot; H Bodenstein; H J Schmoll; H Bleiberg; B Nordlinger; M L Couvreur; B Baron; J A Wils Journal: J Clin Oncol Date: 2000-07 Impact factor: 44.544
Authors: M Ychou; C Astre; P Rouanet; J M Fabre; B Saint-Aubert; J Domergue; D Ribard; A J Ciurana; C Janbon; H Pujol Journal: Eur J Cancer Date: 1996-10 Impact factor: 9.162
Authors: L Leichman; H Silberman; C G Leichman; C P Spears; M Ray; F M Muggia; M Kiyabu; R Radin; L Laine; S Stain Journal: J Clin Oncol Date: 1992-12 Impact factor: 44.544
Authors: Y Yonemura; T Sawa; K Kinoshita; N Matsuki; S Fushida; S Tanaka; S Ohoyama; T Takashima; H Kimura; T Kamata Journal: World J Surg Date: 1993 Mar-Apr Impact factor: 3.352
Authors: Christoph Schuhmacher; Stephan Gretschel; Florian Lordick; Peter Reichardt; Werner Hohenberger; Claus F Eisenberger; Cornelie Haag; Murielle E Mauer; Baktiar Hasan; John Welch; Katja Ott; Arnulf Hoelscher; Paul M Schneider; Wolf Bechstein; Hans Wilke; Manfred P Lutz; Bernard Nordlinger; Eric Van Cutsem; Jörg R Siewert; Peter M Schlag Journal: J Clin Oncol Date: 2010-11-08 Impact factor: 44.544
Authors: Xuguang Chen; Jennifer R Eads; John B Ammori; Aryavarta M Kumar; Tithi Biswas; Jennifer A Dorth Journal: Curr Oncol Rep Date: 2015-04 Impact factor: 5.945