Adjuvant chemotherapy with 5-fluorouracil, doxorubicin and mitomycin-C (FAM) for 6 months after curative resection of gastric carcinoma

Eur J Surg Oncol. 2007 Sep;33(7):843-8. doi: 10.1016/j.ejso.2006.11.030. Epub 2007 Jan 5.

Abstract

Aim: This study aimed to evaluate the efficacy and safety of 5-fluorouracil (5-FU), doxorubicin and mitomycin-C (FAM) adjuvant chemotherapy in patients who had undergone curative resection of gastric carcinoma.

Methods: From Nov 1999 to Jan 2002, 291 consecutive patients with stage IB-IIIB gastric adenocarcinoma were given FAM adjuvant chemotherapy. Chemotherapy comprised intravenous 5-FU 600 mg/m(2) (days 1, 8, 29 and 36), doxorubicin 30 mg/m(2) (days 1 and 29) and mitomycin-C 10 mg/m(2) (day 1), every 8 weeks for 6 months.

Results: The median follow-up time was 60.6 months, 92 patients died, and 93 patients had recurrent disease. The 5-year overall survival (OS) rates were 85.9% for stage IB, 72.1% for stage II, 58.0% for stage IIIA, and 48.2% for stage IIIB (p=0.002). The 5-year relapse-free survival (RFS) rates were 85.2% for stage IB, 71.2% for stage II, 53.3% for stage IIIA, and 39.2% for stage IIIB (p<0.001). A total of 769 cycles of chemotherapy were delivered, and 15 patients experienced grade 3 or higher leukopenia. The most common grade 3 or higher non-hematologic toxicity was nausea/vomiting (11 patients), followed by stomatitis (3 patients).

Conclusions: Adjuvant chemotherapy with FAM for 6 months for gastric carcinoma indicated comparable RFS and OS with an acceptable toxicity profile.

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Doxorubicin / administration & dosage
  • Doxorubicin / therapeutic use
  • Female
  • Fluorouracil / administration & dosage
  • Fluorouracil / therapeutic use
  • Follow-Up Studies
  • Gastrectomy / methods*
  • Humans
  • Incidence
  • Korea / epidemiology
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage
  • Mitomycin / therapeutic use
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Staging
  • Retrospective Studies
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / surgery
  • Survival Rate / trends
  • Time Factors
  • Treatment Outcome

Substances

  • Mitomycin
  • Doxorubicin
  • Fluorouracil

Supplementary concepts

  • FAM protocol