Chemotherapy in advanced gastric cancer: a controlled, prospective, randomised multi-centre study.

Abstract

SUMMARY Seventy-six patients with advanced gastric adenocarcinoma were studied in a prospective, randomised, controlled trial using vincristine, methotrexate, cyclophosphamide, and 5-fluorouracil in an initiation course and mitomycin-C with 5-fluorouracil as maintenance therapy. Thirty-seven patients were inoperable and 39 had the primary tumour resected with histological evidence of residual disease. Survival in the inoperable group was short and showed no significant difference between treated and control patients. The median survival times for treated and control groups were 9.5 and 9.0 weeks respectively. In the resected patients there was no difference in ultimate overall survival between the groups but up to 20 weeks there was a suggestion that the probability of survival in treated patients was higher (P=0.06). The patients were well-matched and it is concluded that chemotherapy has had an early effect but that a further trial with more detailed stratification, particularly of staging and histological grade, is needed. No patient received treatment for longer than two years and unacceptable toxicity occurred in only two patients. Nausea occurred more frequently in the treated group but was short-lived and clinically manageable.

Somatostatin binding in normal and malignant human gastrointestinal mucosa

“…Advanced tumours are associated with a poor prognosis, marginally improved by chemotherapeutic regimens. Any benefit from systemic therapy is usually abrogated by systemic toxicity (Rake et al, 1979;Engstrom et al, 1985;Bleiberg, 1990). For this reason a non-toxic, effective, treatment modality would be of value to improve the outlook for those patients with advanced disease.…”

Tratamento paliativo do adenocarcinoma gástrico

“…However, at least three studies of the decade have not confirmed these results 18,28,33 . With the evolution of both chemotherapy and supportive care, new studies in the 90´s showed clear benefit in favor of palliative chemotherapy.…”

Testing for HIV: the medicolegal view.

“…No randomised trials have compared single agents with no treatment, but two studies have compared combination treatment containing fluorouracil with no treatment. '6 17 These failed to show that chemotherapy prolonged survival but can be criticised because the prognostic factors favoured the no treatment arms. Randomised trials have thus not proved that single agent or combination chemotherapy prolongs survival in patients with advanced stomach cancer.…”