J Gastric Cancer.  2016 Sep;16(3):177-181. 10.5230/jgc.2016.16.3.177.

Efficacy and Safety of Bolus 5-Fluorouracil and L-Leucovorin as Salvage Chemotherapy for Oral Fluoropyrimidine-Resistant Unresectable or Recurrent Gastric Cancer: A Single Center Experience

• Muranaka T
• Yuki S
• Komatsu Y
• Sawada K
• Harada K
• Kawamoto Y
• Nakatsumi
• Sakamoto N

• KMID: 2372561
• DOI: http://doi.org/10.5230/jgc.2016.16.3.177

Abstract

PURPOSE
The International Organization for Standardization-5fluorouracil (FU) 10 trial found that bolus 5-FU and l-leucovorin was not inferior to S-1 in the treatment of gastric cancer (GC). Continuous 5-FU and the rapid injection of 5-FU have different anti-cancer effects. Thus, bolus 5-FU and l-leucovorin treatment might be useful for oral FU-resistant GC.
MATERIALS AND METHODS
We retrospectively analyzed the medical records of all patients with S-1 or capecitabine-resistant, unresectable, or recurrent GC treated with bolus 5-FU and l-leucovorin between January 2010 and December 2015 at Hokkaido University Hospital. The bolus 5-FU and l-leucovorin regimen consisted of intravenous l-leucovorin (250 mg/m²/2 h) and bolus 5-FU (600 mg/m²) administered once weekly followed by a 2-week rest period; each cycle was repeated every 8 weeks.
RESULTS
A total of 14 patients were identified. The disease control rate was 35.7%. The median progression-free survival was 1.6 months (95% confidence interval [CI], 1.3~2.0 months), and the median overall survival was 6.3 months (95% CI, 4.7~7.9 months). No patient died from treatment-related causes. The most common severe adverse event associated with bolus 5-FU and l-leucovorin was neutropenia, which occurred in 21.4% of patients.
CONCLUSIONS
Bolus 5-FU and l-leucovorin treatment might be useful for oral FU-resistant GC. We are planning a multi-center prospective phase II trial to evaluate the efficacy and safety of bolus 5-FU and l-leucovorin treatment for pre-treated unresectable or recurrent GC to confirm the results of this limited, retrospective study.

Keyword

Stomach neoplasms; Drug therapy; 5-fluorouracil; Leucovorin

MeSH Terms

Disease-Free Survival
Drug Therapy*
Fluorouracil*
Humans
Leucovorin
Medical Records
Neutropenia
Prospective Studies
Retrospective Studies
Stomach Neoplasms*
Fluorouracil
Leucovorin

Figure

• 

  Fig. 1 Progression-free survival (PFS). The median PFS was 1.6 months (95% confidence interval, 1.3~2.0 months).

• 

  Fig. 2 Overall survival (OS). The median OS was 6.3 months (95% confidence interval, 4.7~7.9 months).

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