Mitomycin C as an Adjuvant in Resected Gastric Cancer

Abstract

As a result of their previous experience with mitomycin C at high discontinuous doses in advanced gastric cancer, the authors studied its role as an adjuvant for locally advanced cases after surgical complete resection. Results from 70 evaluable patients are presented. Patients were allocated randomly to receive mitomycin C, 20 mg/m2 I.V. direct once every 6 weeks, four courses, or a placebo. After a follow-up period of 250 weeks, seven patients of treatment arm and 23 controls have already relapsed (p less than 0.001). Toxicity was moderate and controllable by symptomatic measures. The authors consider this investigation a positive contribution in the field of adjuvant therapy of gastric cancer.

Adjuvant chemotherapy for gastric cancer: a comprehensive review

“…In these patients, it is questionable whether or not curative surgery had been conducted, and it seems to be difficult to achieve positive results with postoperative adjuvant chemotherapy in these patients with a poor prognosis. In 1983, Alcobendas et al [39] reported on a trial that compared treatment with MMC to observation alone after surgery. Although there was a significant survival advantage for treatment with MMC, the number of patients was very small and the follow-up …”

A Systematic Overview of Chemotherapy Effects in Gastric Cancer

“…No attempt was made to identify ongoing trials with unpublished results. For studies published more than once during follow-up, only the last: nal version, or the one presenting the most detailed results, have been included (24)(25)(26)(27)(28)(29)(30)(31). Two studies included in the earlier meta-analysis (23), one using immuno-therapy and the other only published in Japanese, were excluded in this analysis.…”

Adjuvant therapy in resectable gastric cancer

“…The majority of them gives no details on the procedure (Harrisson et al, 1989;Tonnesen et al, 1988;Moertel et al, 1984;Engstrom et al, 1985;Hugier et al, 1980;Nakajima et al, 1978;Nakajima et al, 1980;Maehara et al, 1990;Schlag, 1987;Lise et al, 1989;Allum et al, 1989c;Koyama et al, 1986;Higgins et al, 1983;Popiela et al, 1988;GITSG, 1982;Blake et al, 1981;Alcobendas et al, 1983) some lay down guidelines for surgical procedure (Coombes et al, 1990;Ochiai et al, 1983;Serlin et al, 1969;GITSG, 1982;IGTSG, 1988) or recommend a specific type of resection (Allum et al, 1989b). None had organised a pathological review of all operative specimens (Coombes et al, 1990).…”

“…Among the six trials showing a benefit on survival in favour of the investigational treatment, two were testing chemotherapy agents (Alcobendas et al, 1983;GITSG, 1982), three immunotherapy (Ochiai et al, 1983;Koyama et al, 1986;Youn et al, 1989) and one the histamine-2-receptor antagonist cimetidine.…”

“…Chemotherapy consisted of Mitomycin C (Alcobendas et al, 1983) and 5FU/MeCCNU (GITSG, 1982). Mitomycin C was given at the dose of 20 mg m-2 every 6 weeks for four consecutive cycles.…”