Irinotecan, leucovorin and 5‑fluorouracil (modified FOLFIRI) as salvage chemotherapy for frail or elderly patients with advanced gastric cancer
- Authors:
- Jung Han Kim
- Hyeong Su Kim
- A Rum Han
- In Ho Moh
- Doo Cheol Chung
- Dae Ro Choi
- Hyun Joo Jang
- Jin Bae Kim
- Dae Hyun Yang
- Soon Il Lee
- Dae Young Zang
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Affiliations: Department of Internal Medicine, Hallym Medical Center, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 150‑950, Republic of Korea , Department of Surgery, Hallym Medical Center, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 150‑950, Republic of Korea , Department of Hemato‑Oncology, Dankook University Hospital, Dankook University College of Medicine, Choenan 330‑715, Republic of Korea
- Published online on: July 2, 2012 https://doi.org/10.3892/ol.2012.782
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Pages:
751-754
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Abstract
We retrospectively evaluated the efficacy and safety of the modified FOLFIRI regimen in frail or elderly patients with advanced gastric cancer (AGC). We reviewed 24 frail [Eastern Cooperative Oncology Group performance status (ECOG PS) of 2] or elderly (65 years or over) patients with AGC who received the modified FOLFIRI regimen as salvage chemotherapy. Patients received irinotecan 150 mg/m2 and leucovorin (LV) 100 mg/m2 as a 2 h intravenous infusion, followed by 5-fluorouracil (5‑FU) 2,000 mg/m2 as a 46 h continuous infusion. Among the 24 patients, 18 (75%) had an ECOG PS of 2, and 11 (45.8%) were aged 65 years or over. A total of 113 cycles were conducted, with a median number of 4 cycles per patient. A total of 3 patients achieved partial response (PR) and 8 demonstrated stable disease (SD). On an intent‑to‑treat basis, the overall response rate (RR) was 12.5% and the disease control rate (PR and SD) was 45.8%. The median time to progression (TTP) was 2 months [95% confidence interval (CI), 1.9‑2.1 months] and the median overall survival (OS) was 5.4 months (95% CI, 4.1‑6.7 months). Grade 3‑4 hematological toxicities, including neutropenia, anemia and thrombocytopenia, were observed in 6 (25%), 4 (16.7%) and 1 (4.2%) patients, respectively. Additionally, 3 (12.5%) patients developed febrile neutropenia, of which 1 succumbed to pneumonia. Grade 3‑4 gastrointestinal toxicities, including nausea, vomiting, diarrhea and mucositis, were observed in 3 (12.5%), 2 (8.3%), 1 (4.2%) and 1 (4.2%) patients, respectively. In conclusion, the modified FOLFIRI regimen as salvage chemotherapy for AGC patients over 65 years of age or with a poor PS was effective and acceptable. These results suggest that this regimen may be an effective option for frail or elderly patients with AGC.
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