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

Sun Hyung Kang; Jeong Il Kim; Hee Seok Moon; Seok Hyun Kim; Jae Kyu Sung; Byung Seok Lee; Hyun Yong Jeong

doi:10.4166/kjg.2010.55.1.26

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

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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

Original Article

Korean J Gastroenterol 2010;55(1):26-32.

Published online: 21 February 2010

DOI: https://doi.org/10.4166/kjg.2010.55.1.26

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

Sun Hyung Kang, M.D., Jeong Il Kim, M.D., Hee Seok Moon, M.D., Seok Hyun Kim, M.D., Jae Kyu Sung, M.D., Byung Seok Lee, M.D., Hyun Yong Jeong, M.D.

Department of Internal Medicine, Division of Gastroenterology and Hepatology, Chungnam National University College of Medicine, Daejeon, Korea

Correspondence to: Hyun Yong Jeong, M.D. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Chungnam National University Hospital, 640, Daesa-dong, Daejeon 301-721, Korea Tel: +82-42-280-7143, Fax: +82-42-254-4553 E-mail: Jeonghy@cnuh.co.kr

Received 17 February 2009 Accepted 27 August 2009

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.

Keywords: Gastric adenocarcinoma, Oxaliplatin, Irinotecan

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Fig. 1.

Time to progression. There was no statistical difference between two groups.

Fig. 2.

Overall survival. There was no statistical difference between two groups.

Table 1.

Patients Characteristics

Characteristics	No. of patients (%)		p-value
Characteristics	FOLFOX (n=30)	FOLFIRI (n=26)	p-value
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^∗
Response^†	FOLFOX	FOLFIRI	p-value^∗
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)
G	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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