본문 바로가기
KERD
논문KCI 등재

Outcomes of Modified FOLFOX-6 as First Line Treatment in Patients with Advanced Gastric Cancer in a Single Institution; Retrospective Analysis

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

주제분류의학일반

초록

Purpose :Treatment options for patients with advanced gastric cancer remain limited. Few studies have investigated the efficacy and tolerability of the combination regimen of oxaliplatin and 5-fluorouracil with leucovorin for patients with advanced gastric cancer. The goal of this study was to examine the efficacy and toxicity of a modified FOLFOX-6 (mFOLFOX-6) regimen as a first-line chemotherapy regimen for patients with advanced gastric cancer. Materials and Methods :From March, 2006, to December, 2007, 82 patients with advanced gastric cancer received 100 mg/m2 oxaliplatin and 100 mg/m2 leucovorin on the first day of treatment, followed by 2,400 mg/m2 of 5-fluorouracil on the first and second days of treatment every 2 weeks as a first-line treatment. Results :The median age of the enrolled patients was 62 years (range; 30∼75). Out of 82 patients, 34 cases (41.5%) were recurrent cases after curative resection, and the other 48 cases were unresectable or non-curative resectable cases. Their response was evaluated every 6 weeks. The overall response rate was 40.2%, with 2 (2.4%) complete response and 31 (37.8%) partial responses. The median time to progression (TTP) and overall survival (OS) time were 6.0 months (95% confidence interval [CI]: 4.69∼7.31) and 13.0 months (7.99∼18.0), respectively. The grade 3∼4 hematologic toxicities observed included neutropenia (34.1%), thrombocytopenia (7.3%), and anemia (1.2%). The gastrointestinal toxicities observed included grade 3∼4 nausea (9.8%) and vomiting (7.3%). Six patients (7.3%) experienced grade 3 neuropathy. No treatment-related deaths were recorded. Conclusion :The modified FOLFOX-6 regimen is effective and well tolerated as a first-line chemotherapy regimen for patients with advanced gastric cancer.

Abstract

Purpose :Treatment options for patients with advanced gastric cancer remain limited. Few studies have investigated the efficacy and tolerability of the combination regimen of oxaliplatin and 5-fluorouracil with leucovorin for patients with advanced gastric cancer. The goal of this study was to examine the efficacy and toxicity of a modified FOLFOX-6 (mFOLFOX-6) regimen as a first-line chemotherapy regimen for patients with advanced gastric cancer. Materials and Methods :From March, 2006, to December, 2007, 82 patients with advanced gastric cancer received 100 mg/m2 oxaliplatin and 100 mg/m2 leucovorin on the first day of treatment, followed by 2,400 mg/m2 of 5-fluorouracil on the first and second days of treatment every 2 weeks as a first-line treatment. Results :The median age of the enrolled patients was 62 years (range; 30∼75). Out of 82 patients, 34 cases (41.5%) were recurrent cases after curative resection, and the other 48 cases were unresectable or non-curative resectable cases. Their response was evaluated every 6 weeks. The overall response rate was 40.2%, with 2 (2.4%) complete response and 31 (37.8%) partial responses. The median time to progression (TTP) and overall survival (OS) time were 6.0 months (95% confidence interval [CI]: 4.69∼7.31) and 13.0 months (7.99∼18.0), respectively. The grade 3∼4 hematologic toxicities observed included neutropenia (34.1%), thrombocytopenia (7.3%), and anemia (1.2%). The gastrointestinal toxicities observed included grade 3∼4 nausea (9.8%) and vomiting (7.3%). Six patients (7.3%) experienced grade 3 neuropathy. No treatment-related deaths were recorded. Conclusion :The modified FOLFOX-6 regimen is effective and well tolerated as a first-line chemotherapy regimen for patients with advanced gastric cancer.

참고문헌 (23)

  1. Glimelius B, "Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer", Ann Oncol, 8, pp.163~168 (1997)
  2. Janunger KG, "A systematic overview of chemotherapy effects in gastric cancer", Acta Oncol, 40, pp.309~326 (2001)
  3. Kohne CH, "Developments in the treatment of gastric cancer in Europe", Oncology, 14, pp.22~25 (2000)
  4. Wils J, "Chemotherapy of metastatic gastric cancer", Gan To Kagaku Ryoho, 27, pp.395~398 (2000)
  5. Cunningham D, "Capecitabine and oxaliplatin for advanced esophagogastric cancer", N Engl J Med, 358, pp.36~46 (2008)
  6. Van Cutsem E, "Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group", J Clin Oncol, 24, pp.4991~4997 (2006)
  7. de Gramont A, "Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer", J Clin Oncol, 18, pp.2938~2947 (2000)
  8. Goldberg RM, "A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer", J Clin Oncol, 2, pp.23~30 (2004)
  9. Becouarn Y, "Oxaliplatin: available data in noncolorectal gastrointestinal malignancies", Crit Rev Oncol Hematol, 40, pp.265~272 (2001)
  10. Cavanna L, "Oxaliplatin in combination with 5-fluorouracil (5-FU) and leucovorin (LV) in patients with metastatic gastric cancer (MGC)", Am J Clin Oncol, 26, pp.371~375 (2006)
  11. Louvet C, "Phase II study of oxaliplatin, fluorouracil, and folinic acid in locally advanced or metastatic gastric cancer patients", J Clin Oncol, 20, pp.4543~4548 (2002)
  12. Caussanel JP, "Phase I trial of 5- day continuous venous infusion of oxaliplatin at circadian rhythm-modulated rate compared with constant rate", J Natl Cancer Inst, 82, pp.1046~1050 (1990)
  13. Al-Batran SE, "Phase II trial of biweekly infusional fluorouracil, folinic acid, and oxaliplatin in patients with advanced gastric cancer", J Clin Oncol, 22, pp.658~663 (2004)
  14. Ohtsu A, "Chemotherapy for metastatic gastric cacner: past, present, and future", J Gastroenterol, 43, pp.256~264 (2008)
  15. Dank M, "Andormized phase 3 trials of irinotecan (CPT-11)+5FU", folinic acid (FA) vs CDDP+5FU in 1st-line advanced gastric cancer patients, 2005, pp.23, 16~
  16. Boku N, "Randomized phase III study of 5-fluorouracil (5-FU) alone versus combination of irinotecan and cisplatin (CP) versus S-1 alone in advanced gastric cancer (JCOG9912)", J Clin Oncol, 25(18) (2007)
  17. Narahara H, "Randomized phase III study of S-1 alone versus S-1+cisplatin in the treatment for advanced gastric cancer (the SPIRITS trials) SPIRITS: S-1 plus cisplatin vs S-1 in RCT in the treatment for stomach cancer", J Clin Oncol, 25(18) (2007)
  18. Hebbar M, "Phase II trial alternating FOLFOX-6 and FOLFIRI regimens in second-line therapy of patients with metastatic colorectal cancer (FIREFOX study)", Cancer invest, 24, pp.154~159 (2006)
  19. Jee Hyun Kim, "Reduced Dose Intensity FOLFOX-4 as First Line Palliative Chemotherapy in Elderly Patients with Advanced Colorectal Cancer", Journal of Korean Medical Science, 20(5), pp.806~810 (2005), 대한의학회
  20. Hwang WS, "Phase II study of oxaliplatin in combination with continuous infusion of 5-fluorouracil", leucovorin as first-line chemotherapy in patients with advanced gastric cancer, 2008, pp.19, 283~288
  21. De Vita F, "A phase II study of biweekly oxaliplatin plus infusional 5-fluorouracil and folinic acid (FOLFOX-4) as first-line treatment of advanced gastric cancer patients", Br J Cancer, 92, pp.1644~1649 (2005)
  22. Al-Batran SE, "Phase III trial in metastatic gastroesophageal adenocarcinoma with fluorouracil, leucovorin plus either oxaliplatin or cisplatin: a study of the Arbeitsgemeinschaft Internistische Onkologie", J Clin Oncol, 26, pp.1435~1442 (2008)
  23. Maindrault-Goebel F, "Evaluation of oxaliplatin dose intensity in bimonthly leucovorin and 48-hour 5- fluorouracil continuous infusion regimens (FOLFOX) in pretreated metastatic colorectal cancer. Oncology Multidisciplinary Research Group (GERCOR)", Ann Oncol, 11, pp.1477~1483 (2000)

관련 논문AI추천

Efficacy and Safety of Oxaliplatin, 5-Fluorouracil, and Folinic Acid Combination Chemotherapy as First-Line Treatment in Metastatic or Recurrent Gastric Cancer김경하, 김세형, 김찬규, 김한조, 김현정, 박성규, 박희숙, 배상병, 원종호, 윤진아, 은준영, 이규택, 이남수, 이상철, 전영우, 홍대식대한암학회 · Cancer Research and Treatment2011 · 제43권 제3호Oxaliplatin, 5-fluorouracil and Leucovorin (FOLFOX-4) Combination Chemotherapy as a Salvage Treatment in Advanced Gastric Cancer김영생, 박세훈, 박진희, 신동복, 심선진, 이재훈, 조은경, 홍준식대한암학회 · Cancer Research and Treatment2010 · 제42권 제1호Oxaliplatin with Biweekly Low Dose Leucovorin and Bolus and Continuous Infusion of 5-fluorouracil (Modified FOLFOX 4) as a Salvage Therapy for Patients w ith Advanced Gastric Cancer권혁찬, 김성현, 김재석, 김효진, 서성환, Bong-Gun Seo, Dong-Mee Lee, Ji-Hoon Jo, Young-Rak Cho대한암학회 · Cancer Research and Treatment2005 · 제37권 제5호Modified FOLFIRI as Second-Line Chemotherapy after Failure of Modified FOLFOX-4 in Advanced Gastric Cancer고윤호, 김태희, 노상영, 박지찬, 원혜성, 전은경, 정승은, 홍숙희, 홍영선대한암학회 · Cancer Research and Treatment2011 · 제43권 제3호Oxaliplatin, 5-FU, Folinic Acid as First-line Palliative Chemotherapy in Elderly Patients with Metastatic or Recurrent Gastric Cancer김병수, 김지현, 오도연, 이근욱, 이종석, 최인실대한암학회 · Cancer Research and Treatment2007 · 제39권 제3호Oxaliplatin with Biweekly, Low Dose Leucovorin and Bolus and Continuous Infusion 5-fluorouracil (Modified FOLFOX 4) as First-line Therapy for Patients with Metastatic Colorectal Cancer권혁찬, 김성현, 김재석, 김효진, 박종성, Kyoung Tae Kim, Shin Ae Lee대한암학회 · Cancer Research and Treatment2004 · 제36권 제2호

이 간행물의 다른 논문 (9건)