5-Fluorouracil, Doxorubicin, and Mitomycin (FAM) Combination Chemotherapy for Advanced Gastric Cancer

Macdonald, John S.; Schein, Philip S.; Woolley, Paul V.; Smythe, Tarilyn; Ueno, Winston; Hoth, Daniel F.; Smith, Frederick P.; Boiron, M; Gisselbrecht, Christian; Brunet, René; Lagarde, C

doi:10.7326/0003-4819-93-4-533

Cited by 334 publications

(115 citation statements)

References 7 publications

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“…Intravenous 5FU infusion [10] or in combination with other anticancer drugs, FAM [11], FAMTX [7] have been used for chemotherapy of advanced gastric cancer. Recently, Ajani reported that DCF therapy (a combination chemotherapy using docetaxel, CDDP and 5FU) showed a significant better survival than CF (CDDP þ 5FU) therapy [12].…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of bidirectional chemotherapy for treatment of patients with peritoneal dissemination from gastric cancer: Selection for cytoreductive surgery

Yonemura¹,

Endou

Shinbo

et al. 2009

Journal of Surgical Oncology

116

112

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There is no standard treatment for peritoneal carcinomatosis (PC) from gastric cancer. New bidirectional chemotherapy (neoadjuvant intraperitoneal-systemic chemotherapy protocol (NIPS)) was developed. The aim of the present study was to assess the safety and efficacy of NIPS and to show the selection for cytoreductive surgery on PC from gastric cancer. Seventy-nine patients with PC from gastric cancer were treated with NIPS. A peritoneal port system was introduced into the abdominal cavity. The peritoneal wash cytological examination through a port was done before and after NIPS. The patients were treated with oral TS-1 twice a daily for 21 days, followed by a 1-week rest. On day 1, 8, and 15 from the start of oral TS-1 administration, 30 mg/m 2 of Docetaxel and 30 mg/m 2 of cisplatinum with 500 ml of saline were introduced into the peritoneal cavity through the port. A median course of oral TS-1 was 2.1 course and a median time of IP chemoterapy was 5.8. Peritoneal free cancer cells (PFCCs) had been detected in 65 (82.2%) patients before NIPS, and the positive cytology changed to be negative in 41 (63.0%) patients after NIPS. After NIPS, 41 patients underwent laparotomy, and complete cytoreduction was done in 32 (78%) patients. Complete cytoreduction was done in 27 (51.9%) of 52 patients with negative cytology but in only 4 (14.8%) of 27 patients with positive cytology (P < 0.001). Patients with negative cytology after NIPS survived significantly longer than those with positive cytology. The adverse effects after NIPS were mild and there was no treatment-related deaths. The grade 3/4 hematological adverse effects were found in 2 (2.6%) patients. Grade 3 renal toxicity and port site infection was found in three patients, respectively. NIPS using a port system is a safe and effective treatment for PC. Peritoneal wash cytology through a port system is a good indicator to select the patients to perform cytoreductive surgery.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of bidirectional chemotherapy for treatment of patients with peritoneal dissemination from gastric cancer: Selection for cytoreductive surgery

Yonemura¹,

Endou

Shinbo

et al. 2009

Journal of Surgical Oncology

116

112

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“…Various treatment regimens have been developed (5,6,9) and have improved the survival of patients with advanced or recurrent gastric cancer (21). The rationale for the design of the combination therapy of docetaxel and S-1 was the significant Comparison of OS in patients between the curative resection and palliative groups.…”

Section: Discussionmentioning

confidence: 99%

Preliminary trial of adjuvant surgery for advanced gastric cancer

Suzuki

Tanabe²,

Taomoto³

et al. 2010

Oncology Letters

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Abstract. In patients with stage IV gastric cancer, systemic chemotherapy is the key treatment. Combination chemotherapy (cis-diamminedichloride platinum plus S-1 and docetaxel plus S-1) results in long-term survival in clinical practice. In selected cases, additional (adjuvant) surgery may result in further longterm survival. This study aimed to evaluate the efficacy of adjuvant surgery following the response to chemotherapy for advanced gastric cancer. Based on response to chemotherapy, the indications for adjuvant surgery (surgery after the response to chemotherapy) are that resection is expected to be curative rather than palliative, provided that no other distant metastases occur. The study included 20 advanced gastric cancer patients who had undergone gastrectomies after the response to the combination chemotherapy of docetaxel and S-1, between September 2003 and December 2008 at Hiroshima University Hospital. At a median follow-up of 980 days, the median overall survival was 855 days. A 2-and 3-year survival was observed in 80 and 54.9% of patients, respectively, following macroscopic curative surgery. In the palliative group, the median overall survival was 510 days, but a 3-year survival was not observed. In the partial response group, the median overall survival was 865 days and a 3-year survival was observed in 37% of patients. One-year survival was not observed in the stable disease group. The patient survival in the partial response group was statistically more prolonged than in the stable disease group. The median overall survival in patients with liver metastasis was 865 days, while that in patients with peritoneal dissemination was 510 days. In conclusion, adjuvant surgery may be effective in gastric cancer patients diagnosed as stage IV by means of liver or distant lymph node metastasis, except in cases of peritoneal dissemination.

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“…Among combined regimens for systemic chemotherapy for gastric cancer, the most widely used is the FAM combination [5-fluorouracil (5-FU), doxorubicin and mitomycin C] (Macdonald et al, 1980;Haim et al, 1982); a number of FAM modifications, involving the replacement of mitomycin with other drugs or of doxorubicin with epidoxorubicin, have also been investigated (Ogawa et al, 1990;Havlin et al, 1992). In addition, the combination of etoposide, doxorubicin and cisplatin (EAP) as well as the biochemical modulation of 5-FU activity by the addition of leucovorin (Bruckner et al, 1991;Kornek et al, 1992) have proved highly efficacious.…”

mentioning

confidence: 99%

Adjuvant chemotherapy after gastric resection in node-positive cancer patients: a multicentre randomised study

Neri

Leonardis²,

Romano³

et al. 1996

Br J Cancer

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5-Fluorouracil, Doxorubicin, and Mitomycin (FAM) Combination Chemotherapy for Advanced Gastric Cancer

Cited by 334 publications

References 7 publications

Safety and efficacy of bidirectional chemotherapy for treatment of patients with peritoneal dissemination from gastric cancer: Selection for cytoreductive surgery

Safety and efficacy of bidirectional chemotherapy for treatment of patients with peritoneal dissemination from gastric cancer: Selection for cytoreductive surgery

Preliminary trial of adjuvant surgery for advanced gastric cancer

Adjuvant chemotherapy after gastric resection in node-positive cancer patients: a multicentre randomised study

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