Therapeutic Effect Of Oxaliplatin With ELF Regimen In Treatment Of Patients With Advanced Gastric Cancer

PurposeELF (Etoposide, Leucovorin, 5-Fu) regimen is used in gastric cancer, but the efficacy is not optimizing. Oxaliplatin is a third generation platinum compound with activity against gastric cancer. In order to see whether addition of oxaliplatin to the ELF combination would improve the response rate and survival status with comparative toxicity, we design this regimen to treat our patients with advanced gastric cancer.Patients and methodsOxaliplatin was given at a dose of 100mg/m~2 iv 2hr on day 1, calcium folinate (CF) 200mg/m~2 iv 1/2 hr on day 1-3, 5-fluorouracil (5-Fu) 500mg/m~2 iv 2hr on day1-3 and etoposide 100mg/m~2 iv 3hr on dayl-3. Cycles were repeated every 21 days. Efficacy and safetywere evaluated every 3 cycles and responders were re-confirmed four weeks later.ResultsSixty-nine patients were entered in the study. Patients (44 male, 25 female) had a median age of 53.3 years (range 28-75 years), adenocarcinoma 57 cases and signet ring cell carcinoma 12 cases. 60.9 % had newly diagnosed disease, and 39.1 % had received previous chemotherapy. A total of 297 cycles (mean 4.3 courses per patient, range 1~12) were administered. 62 patients were analyzed for response. There were 7 complete responses and 25 partial responses (response rate 51.6%), stable disease 17/62 (27.4%), progressive disease 13/62(21.0%). The median time to progression was 5.7 months and the median overall survival was 9.2 months. 297 cycles were analyzed for toxicity. The most common hematologic toxicity was anemia (grade 1 73/297, grade 2 11/297, grade 3 2/297), leucopenia (grade 1 88/297, grade 2 36/297, grade 3 28/297), thrombocytopenia (grade 1 40/297, grade 2 18/297, grade 3 5/297) occurred in 29.0%, 51.2% and 21.2% of patients respectively. No grade 4 and grade 5 anemia, leucopenia and thrombocytopenia were observed. The most common non-hematologic toxicity was nausea and vomiting occurred in 46.5%( grade 1 71/297, grade 2 41/297, grade 3 26/297) and 41.1%( grade 1 68/297, grade 2 35/297, grade 3 19/297), respectively. Peripheral sensory neuropathy (grade 1 85/297, grade 2 36/297, grade 3 19/297) was noted in 47.1% cycles.Alopecia were noted in 181 cycles (60.9%).ConclusionsThis Oxaliplatin / ELF regimen shows good efficacy and an acceptable safety profile in advanced gastric cancer patients.