Adjuvant chemoradiotherapy combined with cisplatin, 5-fluorouracil and folinic acid for locally advanced gastric cancer

Abstract

Aim: This study retrospectively assessed the efficacy and tolerability of combination chemotherapy with cisplatin, infusional 5-fluorouracil and folinic acid given every two weeks and subsequent chemoradiotherapy with continuous infusions of 5-fluorouracil, in gastric cancer following curative resection. Methods: Between August 2007 and January 2014, 58 patients received adjuvant cisplatin 50 mg/m2, leucovorin 400 mg/m2, 5-fluorouracil 400 mg/m2 IV bolus and 5-fluorouracil 2400 mg/m2 as 48-h continuous infusion, every 14 days for gastric adenocarcinoma. After the first 2 cycles of chemotherapy, adjuvant radiation therapy was administered concurrently with the continuous infusion of 5-fluorouracil. Following the completion of radiation therapy, patients received another 4 cycles of combination chemotherapy. Results: A total of 58 patients were included in this study and out of these, 41 patients were male and the median age was 53.5 years. 81% of the patients (n = 47) could complete 6 courses of planned chemotherapy. The median follow-up time was 31.4 (9.33–88.77) months, the median disease free survival (DFS) was 26.43 (95% CI: 49.38–69.95) months. The median overall survival (OS) was 28.53 (95% CI: 49.46–69.55) months. The estimated 3-year DFS and OS rates were 58.75% and 64.04% respectively. Common grade 3 and 4 side effects were weakness (18.9%), nausea and vomiting (12%), diarrhea (10.3%) and neutropenia (10.3%). Conclusion: The addition of combination chemotherapy with cisplatin, infusional 5-fluorouracil and folinic acid before and after chemoradiotherapy was found to be safe and effective in patients with operated gastric cancer.

Keywords

• Adjuvant treatment
• Chemotherapy
• Cisplatin
• Gastric cancer
• Radiotherapy