Journal List > Korean J Gastroenterol > v.55(1) > 1006656

Kang, Kim, Moon, Kim, Sung, Lee, and Jeong: Oxaliplatin and Leucovorin Plus Fluorouracil Versus Irinotecan and Leucovorin Plus Fluorouracil Combination Chemotherapy as a First-line Treatment in Patients with Metastatic or Recurred Gastric Adenocarcinoma

Abstract

Background/Aims

We performed retrospective study in order to compare oxaliplatin, leucovorin, and fluorouracil (FOLFOX) versus irinotecan, leucovorin, and fluorouracil (FOLFIRI) in recurred or metastatic gastric adenocarcinoma.

Methods

We investigated 56 patients who were diagnosed with recurred or metastatic gastric adenocarcinoma in a single center during march, 2003 to march, 2008. The patients received either FOLFOX or FOLFIRI chemotherapy.

Results

There were no significant difference between the Oxaliplatin group (30 patients) and Irinotecan group (26 patients) in sex, age, and ECOG performance (p>0.05). Oxaliplatin group showed 1 case of CR (3.3%) and 12 cases of PR (40%), making the response rate 43.3%. Irinotecan group showed CR in 2 cases (7.7%) and PR in 10 cases (38.5%), making the response rate 46.2%. The median value of time to progression was 4 months in the oxlaplatin group and 4.5 months in the irinotecan group. The overall survival showed no significant difference (p=0.784), with the irinotecan group (9.7 months) being slightly longer than the Oxaliplatin group (8.3 months). Grade 3/4 neutropenia occurred similarly in both groups (4 cases in the oxalplatin group, 9 in the irinotecan group).

Conclusions

Both combination treatment can be used safely and effectively in recurred or metastatic gastric adenocarcinoma.

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Fig. 1.
Time to progression. There was no statistical difference between two groups.
kjg-55-26f1.tif
Fig. 2.
Overall survival. There was no statistical difference between two groups.
kjg-55-26f2.tif
Table 1.
Patients Characteristics
Characteristics No. of patients (%) p-value
FOLFOX (n=30) FOLFIRI (n=26)
Age (years, median, 56.47 56.23 0.624
range) (25-78) (36-74)
Sex (Male:Female) 20:10 16:10 0.783
Prior surgery (%) 13 (43.3) 21 (80.8) 0.006
Prior adjuvant (%) 14 (46.7) 17 (65.4) 0.187
chemotherapy
ECOG PS (0:1) 14:16 13:13 0.789
(43.3:53.3) (50:50)
Measurable lesion (%) ) 0.331
Liver 16 (53.3) 15 (57.7)
Lymph node 11 (36.7) 7 (26.9)
Ovary 1 (3.3) 4 (15.4)
Lung 1 (3.3) 0 (0)
Adrenal gland 1 (3.3) 0 (0)
Second-line 19 (63.3) 15 (57.7) 0.786
chemotherapy

PS, performance status. Fisher's exact test.

Table 2.
Treatment Response
Response No. of patients (%) p-value
FOLFOX FOLFIRI
CR 1 (3.3%) 2 (7.7%) NS
PR 12 (40%) 10 (38.5%) NS
SD 6 (20%) 5 (19.2%) NS
PD 11 (36.7%) 9 (34.6%) NS
CR+PR 13 (43.3%) 12 (46.2%) NS

CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; NS, not significant.

χtest.

RECIST criteria.

Table 3.
Toxicity of Chemotherapy
G FOLFOX (n=30, 170 cycle) FOLFIRI (n=26, 111 cycles)
Grade 1-2 Grade 3-4 Grade 1-2 Grade 3-4
Hematologic
Leukopenia 5 4 5 9
Neutropenia 3 4 5 8
Anemia 7 0 7 0
Thrombocytopenia 2 0 1 0
Non-hematologic
Nausea 17 0 13 0
Omiting 11 0 10 0
Diarrhea 2 0 5 0
Neuropathy 2 1 0 0
Mucositis 2 0 1 0
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