FOLFOX-4 Combination Chemotherapy as a First-line Treatment in Patients with Advanced Gastric Cancer

Lee, Cheon Woo; Park, Moo In; Park, Seun Ja; Moon, Won; Kim, Hyung Hun; Lee, Hae Won; Ku, Ki Hwan; Kim, Bu Kyung

Abstract

BACKGROUND/AIMS
This study examined the efficacy and safety of oxaliplatin-5-fluorouracil-leucovorin (FOLFOX-4) combination chemotherapy as first-line treatment in patients with advanced gastric cancer.
METHODS
This retrospective study enrolled 35 patients diagnosed with pathologically proven surgically unresectable gastric cancer who received FOLFOX-4 combination chemotherapy between August 2006 and February 2009, using medical records. The administered dose of oxaliplatin was 85 mg/m2 for 2 hrs and leucovorin 200 mg/m2 for 2 hrs on day 1, 5-fluorouracil 400 mg/m2 as a bolus and 5-fluorouracil 600 mg/m2 for 22 hrs on days 1 and 2, every 2 weeks. The response was assessed every three cycles. Toxicity was evaluated for every course of chemotherapy according to the NCI toxicity criteria ver. 2.0.
RESULTS
The median patient age was 61 (range 27-77) years. The median overall survival was 8.50 (6.23-10.90) months and the median time to progression was 4.50 (0.38-9.75) months. With FOLFOX-4, there was no complete remission and 19 partial responses, for a response rate of 54.3%. Over 298 cycles, anemia worse than NCI toxicity grade 3 occurred in 1.3%, leukopenia in 1.6%, neutropenia in 9%, and thrombocytopenia in 3.2%. Grade 1-2 neuropathy occurred in 14.7% of the cycles. Neutropenic fever occurred in two cycles and the regimen was changed because of side effects in one cycle.
CONCLUSIONS
FOLFOX-4 has a very high response rate with mild toxicity in patients with advanced gastric cancer as a first-line treatment.