Oxaliplatin,5-Fluorouracil and Leucovorin Combination Chemotherapy in Advanced Gastric Cancer

Objective To determine the efficacy and safety of FOLFOX-4 chemotherapy as a salvage treatment for patients with advanced gastric cancer(AGC).Methods 28 AGC patients with ECOG performance status of 0~2 were registered into this study.Patients received Oxaliplatin(85 mg/m2 on day 1),Leucovorin(200 mg/m2 on days 1 and 2) and 5-Fluorouracil(400 mg/m2 as a bolus and 600 mg/m2 as a 22-hour infusion on days 1 and 2 every 2 weeks.Results For the 28 treated patients,administered median chemotherapy cycles were 6 and range from 4 to 12 cycles.Sixteen patients(57.1%) received FOLFOX-4 chemotherapy as a first-line treatment and 12 patients(42.9%) as a second-line treatment.On the intent-to-treat analysis,none cases achieved complete response(CR),18 patients(64.3%) achieved a partial response(PR),and 8 patients(28.6%) were stable disease(SD)and 2 cases(7.1%) had progression disease(PD).The overall response rate(RR) was 64.3%(18/28),in which first-line treatment patients was 68.8%(11/16)and second-line treatment patients was 58.3%(7/12).There were no significant differences in response rate between patients as a first-line treatment and as a second-line treatment(P0.05).The clinical benefit rate(CR+PR+SD)was 92.9%.The median time to progression(TTP) was 6.1 months and the median overall survival(OS) was 13 months.The most frequent side effects were bone marrow suppression,hepatic damage and gastrointestinal responses.Conclusion Combination chemotherapy with FOLFOX-4 is an effective and tolerable regimen for AGC patients as a first-line treatment and same as a second-line treatment.