J Korean Gastric Cancer Assoc.  2003 Sep;3(3):122-127.

Retrospective Study on the Therapeutic Effects of an Etoposide, Adriamycin, Cisplatin-II (EAP- II) versus an Etoposide, Leucovorin, 5-Furorouracil (ELF) Combination Chemotheraphy in Unresectable Gastric Cancer

• Moon HS
• Kang YS
• Kim YS
• Park KO
• Lee ES
• Sung JK
• Lee BS
• Noh SM
• Song KS
• Cho JS
• Shin KS
• Jeong HY

Abstract

PURPOSE: The incidence rate and the mortality rate of gastric cancer have decreased in developed countries over the last several decades. On the other hand, they remain high in far eastern countries such as Korea, Japan, China and in many developing countries. The cure of patients with gastric carcinomas can be achieved mostly through complete surgical resection, but most gastric cancer patients are in advanced stages when diagnosed and have poor prognoses. therefore, the development of an effective systemic therapy is essential for far advanced gastric cancer patients. Until recently, the most commonly used combination chemotherapy was based on 5-flurouracil or cisplatin, but the results were not satisfactory, so recently etoposide, adriamycin and cisplatin (EAP-II) combination chemotherapy was introduced in patients with advanced gastric cancer. Early studies showed a high response rate and the ability to convert unresectable cases to resectable ones, but later studies couldn`t duplicate the result. the purpose of this study was to evaluate the relative efficacy&toxicity of EAP-II chemotherapy and ELF chemotherapy which is based on 5-flurouracil. MATENRIALS AND METHODS: Between July 1992 and July 2002, sixty-five patients with inoperable advanced gastric cancer were enrolled for this study. Thirty-seven patient received EAP-II chemotherapy:etoposide (20 mg/m2 IV for 1~5 days), adriamycin (20 mg/m2 IV for 1~5 days) and cisplatin (20 mg/m2 IV for 1~5 days) and Twenty-eight patients receieved ELF chemotherapy:etoposide (100 mg/m2 IV for 1~3 days), leucovorin (20 mg/m2 IV for 1~5 days) and 5-FU (500 mg/m2 IV for 1~5 days). Each treatment schedule for each group was repeated every four weeks: EAP-II means 3.4 cycles per patient: ELF means 4.1 cycles per patient
RESULTS
Total respones rates were 5.4% in the ELF group and 3.6% in the EAP group (P-value>0.05). The median times to progression were 144 days in the ELF group and 92 days in the EAP-II group (P-value>0.05), and the median overall survival times were 189 days in the ELF group and 139 days in the EAP-II group (P-value>0.05). The difference in the survival curves for the two regimens was not statistically significant. Non-hematologic toxicitis&hematologic toxicitis were more frequently observed for the EAP-II regimen. Anemia: 27.6% in ELF vs 54% in EAP-II; Leukopenia: 8.5% in ELF vs 19% in EAP-II; nausea&vomiting: 45.9% in ELF vs 67.8% in EAP-II.
CONCLUSION
EAP-II regimen is not superior to ELF regimen in the tratment of inoperable advanced gastric cancer.

Keyword

Etoposide, Adriamycin; Cisplatin; Leucovorin 5-Furorouracil; Stomach cancer

MeSH Terms

Anemia
Appointments and Schedules
China
Cisplatin
Developed Countries
Developing Countries
Doxorubicin*
Drug Therapy
Drug Therapy, Combination
Etoposide*
Fluorouracil
Hand
Humans
Incidence
Japan
Korea
Leucovorin*
Leukopenia
Mortality
Prognosis
Retrospective Studies*
Stomach Neoplasms*
Cisplatin
Doxorubicin
Etoposide
Fluorouracil
Leucovorin