5-Fluorouracil, methotrexate, leucovorin, CDDP and epirubicin (FEPMTX)

A wide-spectrum regimen of salvage chemotherapy for high-grade advanced gastric cancer

Kazuo Kinoshita, Yutaka Yonemura, Toshiharu Sawa, Tatsukazu Miyata, Hiroshi Sakuma, Nobuo Matsuki, Sigehiro Tanaka, Sachio Fushida, Takashi Fujimura, Young Jae Mok, Byung Sik Kim, Jong In Lee, Dong Wook Choi, Young Jin Song, Doo Hyun Yang, Sung Joon Kwon, Motohiro Tanaka, Itsuo Miyazaki

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background/Aims: Twenty-one patients with primary stage IV gastric cancer were treated with a wide-spectrum regimen, designated as FEPMTX therapy to establish an effective salvage chemotherapy. Methodology: FEPMTX therapy consisted of 5-fluorouracil and the triple biochemical modulators in addition to epirubicin. The schedule comprised 3 days continuous administration of 5-fluorouracil (350mg/m2/day) and; methotrexate (MTX; 35mg/m2) on day 1, calcium leucovorin (LV; 30mg/m2) on day 2 and 3, cisplatin (CDDP; 30mg/m2) and epirubicin (20mg/m2) on day 3 every 2 weeks in principle. Results: Eleven partial responses, five no changes and five progressive diseases were obtained, and the response rate was 52%. Ten patients (partial response 7, no change 2, progressive disease 1) received gastrectomy (resectability rate 48%). The survival of responders was significantly longer than that of non-responders (median survival time, 356 days vs. 152 days) while there was no significant prolongation by resection of the primary lesion. Adverse effects such as myelosuppression, anorexia and fatigue sometimes occurred, but were mild and the regimen was well tolerated by all the patients. Conclusions: FEPMTX is thought to be an effective regimen for neoadjuvant chemotherapy with longer survival and little toxicity for patients with high-grade advanced gastric cancer.

Original languageEnglish
Pages (from-to)1716-1719
Number of pages4
JournalHepato-gastroenterology
Volume50
Issue number53
Publication statusPublished - 2003 Sep 1
Externally publishedYes

Fingerprint

Epirubicin
Leucovorin
Methotrexate
Fluorouracil
Stomach Neoplasms
Drug Therapy
Survival
Anorexia
Gastrectomy
Cisplatin
Fatigue
Appointments and Schedules
Therapeutics

Keywords

  • Biochemical modulation
  • Gastric cancer
  • Salvage chemotherapy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Kinoshita, K., Yonemura, Y., Sawa, T., Miyata, T., Sakuma, H., Matsuki, N., ... Miyazaki, I. (2003). 5-Fluorouracil, methotrexate, leucovorin, CDDP and epirubicin (FEPMTX): A wide-spectrum regimen of salvage chemotherapy for high-grade advanced gastric cancer. Hepato-gastroenterology, 50(53), 1716-1719.

5-Fluorouracil, methotrexate, leucovorin, CDDP and epirubicin (FEPMTX) : A wide-spectrum regimen of salvage chemotherapy for high-grade advanced gastric cancer. / Kinoshita, Kazuo; Yonemura, Yutaka; Sawa, Toshiharu; Miyata, Tatsukazu; Sakuma, Hiroshi; Matsuki, Nobuo; Tanaka, Sigehiro; Fushida, Sachio; Fujimura, Takashi; Mok, Young Jae; Kim, Byung Sik; Lee, Jong In; Choi, Dong Wook; Song, Young Jin; Yang, Doo Hyun; Kwon, Sung Joon; Tanaka, Motohiro; Miyazaki, Itsuo.

In: Hepato-gastroenterology, Vol. 50, No. 53, 01.09.2003, p. 1716-1719.

Research output: Contribution to journalArticle

Kinoshita, K, Yonemura, Y, Sawa, T, Miyata, T, Sakuma, H, Matsuki, N, Tanaka, S, Fushida, S, Fujimura, T, Mok, YJ, Kim, BS, Lee, JI, Choi, DW, Song, YJ, Yang, DH, Kwon, SJ, Tanaka, M & Miyazaki, I 2003, '5-Fluorouracil, methotrexate, leucovorin, CDDP and epirubicin (FEPMTX): A wide-spectrum regimen of salvage chemotherapy for high-grade advanced gastric cancer', Hepato-gastroenterology, vol. 50, no. 53, pp. 1716-1719.
Kinoshita, Kazuo ; Yonemura, Yutaka ; Sawa, Toshiharu ; Miyata, Tatsukazu ; Sakuma, Hiroshi ; Matsuki, Nobuo ; Tanaka, Sigehiro ; Fushida, Sachio ; Fujimura, Takashi ; Mok, Young Jae ; Kim, Byung Sik ; Lee, Jong In ; Choi, Dong Wook ; Song, Young Jin ; Yang, Doo Hyun ; Kwon, Sung Joon ; Tanaka, Motohiro ; Miyazaki, Itsuo. / 5-Fluorouracil, methotrexate, leucovorin, CDDP and epirubicin (FEPMTX) : A wide-spectrum regimen of salvage chemotherapy for high-grade advanced gastric cancer. In: Hepato-gastroenterology. 2003 ; Vol. 50, No. 53. pp. 1716-1719.
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T1 - 5-Fluorouracil, methotrexate, leucovorin, CDDP and epirubicin (FEPMTX)

T2 - A wide-spectrum regimen of salvage chemotherapy for high-grade advanced gastric cancer

AU - Kinoshita, Kazuo

AU - Yonemura, Yutaka

AU - Sawa, Toshiharu

AU - Miyata, Tatsukazu

AU - Sakuma, Hiroshi

AU - Matsuki, Nobuo

AU - Tanaka, Sigehiro

AU - Fushida, Sachio

AU - Fujimura, Takashi

AU - Mok, Young Jae

AU - Kim, Byung Sik

AU - Lee, Jong In

AU - Choi, Dong Wook

AU - Song, Young Jin

AU - Yang, Doo Hyun

AU - Kwon, Sung Joon

AU - Tanaka, Motohiro

AU - Miyazaki, Itsuo

PY - 2003/9/1

Y1 - 2003/9/1

N2 - Background/Aims: Twenty-one patients with primary stage IV gastric cancer were treated with a wide-spectrum regimen, designated as FEPMTX therapy to establish an effective salvage chemotherapy. Methodology: FEPMTX therapy consisted of 5-fluorouracil and the triple biochemical modulators in addition to epirubicin. The schedule comprised 3 days continuous administration of 5-fluorouracil (350mg/m2/day) and; methotrexate (MTX; 35mg/m2) on day 1, calcium leucovorin (LV; 30mg/m2) on day 2 and 3, cisplatin (CDDP; 30mg/m2) and epirubicin (20mg/m2) on day 3 every 2 weeks in principle. Results: Eleven partial responses, five no changes and five progressive diseases were obtained, and the response rate was 52%. Ten patients (partial response 7, no change 2, progressive disease 1) received gastrectomy (resectability rate 48%). The survival of responders was significantly longer than that of non-responders (median survival time, 356 days vs. 152 days) while there was no significant prolongation by resection of the primary lesion. Adverse effects such as myelosuppression, anorexia and fatigue sometimes occurred, but were mild and the regimen was well tolerated by all the patients. Conclusions: FEPMTX is thought to be an effective regimen for neoadjuvant chemotherapy with longer survival and little toxicity for patients with high-grade advanced gastric cancer.

AB - Background/Aims: Twenty-one patients with primary stage IV gastric cancer were treated with a wide-spectrum regimen, designated as FEPMTX therapy to establish an effective salvage chemotherapy. Methodology: FEPMTX therapy consisted of 5-fluorouracil and the triple biochemical modulators in addition to epirubicin. The schedule comprised 3 days continuous administration of 5-fluorouracil (350mg/m2/day) and; methotrexate (MTX; 35mg/m2) on day 1, calcium leucovorin (LV; 30mg/m2) on day 2 and 3, cisplatin (CDDP; 30mg/m2) and epirubicin (20mg/m2) on day 3 every 2 weeks in principle. Results: Eleven partial responses, five no changes and five progressive diseases were obtained, and the response rate was 52%. Ten patients (partial response 7, no change 2, progressive disease 1) received gastrectomy (resectability rate 48%). The survival of responders was significantly longer than that of non-responders (median survival time, 356 days vs. 152 days) while there was no significant prolongation by resection of the primary lesion. Adverse effects such as myelosuppression, anorexia and fatigue sometimes occurred, but were mild and the regimen was well tolerated by all the patients. Conclusions: FEPMTX is thought to be an effective regimen for neoadjuvant chemotherapy with longer survival and little toxicity for patients with high-grade advanced gastric cancer.

KW - Biochemical modulation

KW - Gastric cancer

KW - Salvage chemotherapy

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