Weekly high dose 22 hours infusional 5-fluorouracil plus leucovorin and biweekly cisplatin treatment of advanced/ metastatic gastric cancer

Introduction: Prognosis of advanced/metastatic gastric cancer is very poor, best supportive care related overall survival is 3–4 month. The purpose of the study was to asses the activity and toxicity of weekly high dose infusional 5- Fluorouracil associated with weekly Leucovrin and biweekly Cisplatin as first- line chemotherapy in patients with advanced or metastatic gastric cancer.

Material and methods: An open, non-randomized trial was performed involving 37 patients each of which had histlogically confirmed measurable, locally advanced or metastatic gastric cancer. Adequate WHO performance status, hemathological and organ (liver, kidney) functions were needed. Those patients were treated according the following scheme: Leucovrin 300mg/m² for 2 hours infusion followed by 5-Flurouracil 1500mg/m² for 22 hours continous infusion once weekly x 6 and Cisplatin 40mg/m² for 1 hour infusion once biweekly. Between the treatment cycles they were 1 week rest periods. The treatment was continued untill progression.

Results: We did not record complete remission, partial remission was recorded at 8 patients (22%), stabil disease at 22 patients (60%). At 7 of our patients we registered progressive disease (18%). The median overall survival was 9,1 month, the median progression free survival was 5,9 month. The principal adverse events were: nausea/ vomiting, superficial phlebitis and anaemia. Grade 3–4 neutropenia and mycositis were rare.

Conclusion: The treatment of advanced gastric cancer according to the scheme mentioned above shoes good results regardind respone rate and survival, the treatment was well tolerated and favorable cost-effective.