Erciyes Tip Dergisi, vol.25, no.1, pp.16-20, 2003 (SCI-Expanded)
Purpose: Gastric cancer is usually diagnosed in advanced stage. Chemotherapy has limited efficacy in advanced gastric cancer. Patients and Method: Ninety-six advanced gastric cancer patients who had been given a palliative chemotherapy in Erciyes University Medical Faculty were evaluated retrospectively. Results: Fourty-three patients (44.8%) had palliative surgery (34 total gastrectomy, 9 subtotal gastrectomy), 56 had adenocarcinoma, 37 had signet ring cell carcinoma and 3 had mucinous adenocarcinoma. Twenty-five patients (26.0%) were treated with 5 fluorouracil (5-FU) 425 mg/m2 for 5 days and folinic acid 20 mg/m2 for 5 days every 4 week for 6 cycles (FUFA); 19 patients (19.8%) were given 5 FU 400 mg/m2 every week during 6 months (Weekly FU); 41 patients (42.7%) were treated with 5 FU 600 mg/m2 days 1,8,29,36, doxorubucin 30 mg/m2 days 1,29 and mitomycin 10 mg/m2 day 1 every 8 week for 6 cycles (FAM) and 11 patients (11.5%) had one of other chemotherapy protocols. Median progression free survival (PFS) in all patients was calculated as 9.0±1.64 months (95% CI 5.79-12.21) and overall survival (OS) was 12.0±3.13 months (95% CI 5.87-18.13). The two year PFS rate was 12.4% and OS rate was 20.8%. There was no statistically significant difference in terms of survival between chemotherapy regimens. PFS and OS seemed better in the first year in patients who had palliative surgery but this difference disappeared in the following years. Conclusion: Chemotherapy regimens have limited activity in advanced gastric cancer. More effective chemotherapy regimens are therefore needed in the light of further investigations.