Advances in the treatment of patients with gastric adenocarcinoma

Figures & data

Figure 1.  Adjuvant radiotherapy after distal subtotal gastrectomy (A) 3D dose plan. The red line depicts the planning target volume (PTV) and the red area 95% of the prescribed dose (B) Dose volume histograms for the PTV and organs at risk.

Table I.  Phase III studies supporting the use of the currently recommended combination chemotherapy regimens for the palliative treatment of gastric cancer.

Study	No. of patients	Regimen	Response rates (95% confidence intervals)	Median survival in months	p on survival
Webb et al. [45]	274	ECF	45% (36% to 54%)	8.9	p = 0.0009
		FAMTX	21% (13% to 29%)	5.7
Ross et al. [46]	580	ECF	42.4% (37% to 48%)	9.4	p = 0.315 *
		MCF	44.1% (38% to 50%)	8.7
Cunningham et al. [48]	1002	ECF	41%**	NR***	NR***
		EOF	42%**	NR***
		ECX	46%**	NR***
		EOX	48%**	NR***
Van Cutsem et al. [55]	457	DCF	37% (30.3% to 43.4%)	9.2	p = 0.02
		CF	25% (19.9% to 31.7%)	8.6
Dank et al. [54]	337	IFL	32%	9	p = 0.530
		CF	26%	8.7

*QOL scores were significantly better with ECF. **Preliminary results as presented at ASCO 2006. ***Not finally reported.

ECF = Epirubicin, Cisplatin, 5-FU; FAMTX = 5-FU, Doxorubicin, Methotrexate; MCF = mitomycin, cisplatin, 5-FU; EOF = Epirubicin, Oxaliplatin, 5-FU; ECX = Epirubicin, Cisplatin, Capecitabine; EOX = Epirubicin, Oxaliplatin, Capecitabine; DCF = Doxetaxel, Cisplatin, 5-FU; CF = Cisplatin, 5-FU; IFL = Irinotecan, 5-FU, Folinic acid.

Webb A, Cunningham D, Scarffe JH, Harper P, Norman A, Joffe JK, et al. Randomized trial comparing epirubicin, cisplatin, and fluorouracil versus fluorouracil, doxorubicin, and methotrexate in advanced esophagogastric cancer. J Clin Oncol 1997; 15: 261–7

 PubMed Web of Science ®Google Scholar

Ross P, Nicolson M, Cunningham D, Valle J, Seymour M, Harper P, et al. Prospective randomized trial comparing mitomycin, cisplatin, and protracted venous-infusion fluorouracil (PVI 5-FU) with epirubicin, cisplatin, and PVI 5-FU in advanced esophagogastric cancer. J Clin Oncol 2002; 20: 1996–2004

 PubMed Web of Science ®Google Scholar

Cunningham D, Rao S, Starling N, Iveson T, Nicolson M, Coxon F, et al. Randomised multicentre phase III study comparing capecitabine with fluorouracil and oxaliplatin with cisplatin in patients with advanced oesophagogastric (OG) cancer: The REAL 2 trial. J Clin Oncol (Meeting Abstracts) 2006; 24: LBA4017

 Google Scholar

Van Cutsem E, Moiseyenko VM, Tjulandin S, Majlis A, Constenla M, Boni C, et al. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: A report of the V325 study group. J Clin Oncol 2006; 24: 4991–7

 PubMed Web of Science ®Google Scholar

Dank M, Zaluski J, Barone C, Valvere V, Peschel C, Wenczl M. Randomized phase 3 trial of irinotecan (CPT-11) + 5FU/folininc acid (FA) vs CDP + 5FU in 1st-line advanced gastric cancer patients. J Clin Oncol 2005; 23: 308s(Abstr: 4003)

 Google Scholar