Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 22, No 14S (July 15 Supplement), 2004: 4258
© 2004 American Society of Clinical Oncology

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Abstract

Adjuvant chemotherapy for gastric carcinomas with positive lymph nodes: Experience with a weekly schedule of irinotecan + 5 FU + folinic acid

Averoes Oncology Center, Casablanca, Morocco

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Background: Locally advanced gastric carcinoma is very frequent in Morocco. In spite of a surgery often satisfactory and an adjuvant chemotherapy based on 5 FU+ Cisplatine, the 2 years survival remains low hardly passing the 50% . Moreover, the precarious performance status of patients make the haematological and renal toxicity of this protocol at the limit of the acceptability. The goal of this work is to evaluate the efficiency and the tolerance of a new protocol delivered in a weekly schedule including the irinotécan, the 5 FU and the folinique acid. Methods: It is a prospective study led between September 2000 and September 2001 that included 34 patient with gastric carcinoma. All patients had total gastrectomy with lymphadenectomy. Nodal involvement was present in 100 %. The middle age was of 43 years and the sex ratio of 5. On the histological plan, 28 patients had a well differentiated adenocarcinoma and 6 patients an undifferentiated carcinoma. The TNM stage was like follows: T3 in 29 cases and T4 in 5 cases; N1 in 19 cases, N2 in 10 cases and N3 in 5 cases. All patients were free of metastasis. The protocol of chemotherapy consisted in 8 weekly successive injections of: irinotecan 80 mg/m2 + 5 Fluorouracile: 750 mg/m2 + folinic acidic 20 mg/m2. Results: As regards to tolerance, a grade III neutropenia has been observed in 3 cases and a grade II diarrhea observed among 7 patients. at 2 years The disease free survival was 61%. Conclusions: The weekly schedule of irinotécan +5 FU + F.A is well tolerated. The 2 years DFS is increased with this protocol to 61%. These results are very promising and deserve to be confirmed on a large trial.

No significant financial relationships to disclose.