A comparison of combination chemotherapy with FOLFOX4 regimen and leucovorin,tegafur,oxaliplatin regimen for treatment of advanced gastric cancer

Objective:To compare the efficacy and toxicity of combination chemotherapy with FOLFOX4 regimen versus leucovorin,tegafur and oxaliplatin regimen for treatment of advanced gastric cancer.Methods:Total of 75 patients with advanced gastric cancer proved pathologically were divided into 2 groups according to the admission date,39 cases received FOLFOX4 regimen[oxaliplatin 85mg/m2 as a 2-hour infusion on d1 and a 2-hour infusion of LV(200mg/m2 ·d) followed by 5-FU bolus(400mg/m2 ·d) and 22-hour infusion(600mg/m2 ·d) for 2 consecutive days every 2 weeks].Leucovorin,tegafur and oxaliplatin regimen[oxaliplatin 130mg/m2 as a 2-hour infusion on d1,a 2-hour infusion of LV(200mg/m2 ·d) followed by 2-6 hours infusion(800mg/m2 ·d) on d1-5 every 3 weeks] was applied in the other group including 36 cases.Efficacy was evaluated at least 3 cycles.Results:In 39 cases with FOLFOX4 regimen,overall response(CR + PR) rate was 41.0%(55.6% in untreated cases and 28.6% in retreated cases),meanwhileital,in the other group,overall response rate was 38.9%(50.0% in untreated cases and 30.0% in retreated cases).No significant differences were found between two groups in overall response rate.The major toxicity was reversible bone marrow suppression,adverse reaction of digestive system and peripheral sensory neuropathy,the rates of white blood cells deceasing and adverse digestive reaction were higher in FOLFOX4 group than those in the other group(all P0.05).No death correlated with chemotherapy.Conclusion:FOLFOX4 regimen and leucovorin,tegafur,oxaliplatin regimen are both effective.Nevertheless,overall response rate of FOLFOX4 is higher than LFP.Toxicity is well-tolerated.So,FOLFOX4 seemed beneficial as first-line therapy in advanced gastric cancer.The aged and weak cases may choose leucovorin,tegafur,oxaliplatin regimen.