Clinical study of oxaliplatin combination chemotherapy with hydroxycamptothecin, fluorouracil and leucovorin in advanced gastric cancer

OBJECTIVE:To evaluate the effects and safety of oxaliplatin (L-OHP), hydroxylcamptothecin (HCPT), Fluorouracil (5-FU) and leucovorin (LV) combined HLOF regimen, compared with Cisplatin (DDP), HCPT, 5-FU and LV combined HLOF regimen in the treatment of patients with advanced and metastatic gastric cancer. METHODS: Sixty-one cases were randomly grouped, and 32 cases were treated as study group with HLOF regimen while 29 cases were treated with HLPF regimen as control: L-OHP 130 mg/m2 iv gtt 2 hours d_1, HCPT 6 mg/m2 iv gtt d_1-d_5, DDP 30 mg/m2 iv gtt d_1-d_3, 5-FU 500 mg/m2 iv gtt d_1-d_3, LV 100 mg/m2 iv gtt d_1-d_3. Both regiment were repeated in 21-28 days. All patients completed at least two cycles for evaluation.RESULTS: There were 2 cases of CR, 17 cases of PR,8 cases of SD and 5 cases of PD in HLOF regimen group with overall response rate (ORR) of 59.4%, and 12 cases PR,11 cases of SD and 6 cases PD with ORR of 41.4% in HLPF regimen group, respectively. There was no statistically significant difference of ORR and RR of initial treatment and retreatment between the two groups, P0.05. The decreased appetite, nausea and vomiting were lower in HLOF group than in HLPF group, P0.05; but neurotoxicity was more common in HLOF regimen group. The post-therapy KPS score in both groups increased in a large number of patients but HLOF regimen group seemed achieved higher score grade, P0.05. No differences were found between the two groups in time to progress (TTP) and survival time, both P0.05. CONCLUSIONS:Both regimens are efficient and low-toxic in the treatment of advanced gastric cancer. The patients would be more likely benefit from HLOF regimen than from HLPF regimen for decreasing gastrointestinal discomfort and increasing quantity of life (QOL).