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Review of adjuvant chemotherapy for gastric cancer

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Abstract

Controlled randomized studies that compared surgery alone to adjuvant chemotherapy for gastric cancer were reviewed. The amount of residual tumor after surgery, selection of drug regimens, compliance with drug administration, and trial design seem to be responsible for the success of adjuvant chemotherapy. Though there are few beneficial regimens of adjuvant chemotherapy with statistical significance, single drug therapy with mitomycin C (MMC) and combination therapy with 5-fluorouracil (5FU) and methyl-CCNU, MMC/5FU/cytosine arabinoside (MFC), and 5FU/Adriamycin/MMC (FAM) seem to have potential survival benefit for patients with curative surgery. Incorporation of new drugs into adjuvant or neoadjuvant chemotherapy might open a new aspect of multimodality therapy for gastric cancer.

Résumé

Ont été analysées iei les seules études contrôlées, randomisées, comparant la chirurgie seule et la chimiothérapie adjuvante dans le traitement du cancer gastrique. La masse de tissu résiduel restant après la chirurgie, la sélection de traitements chimiothéraquetiques, la compliance aux traitements et les structures des essais sont peut-être pour quelque chose dans le succés de la chimiothérapie adjuvante. Bien qu'il y ait peu d'études montrant des différences statistiquement significatives, les thérapies comportant seulement du MMC, celles combinant le 5 FU et le Méthyl CCNU, la MFC, et le FAM semblent pouvoir entraîner une survie supérieure dans les groupes comportant une chirurgie à visée curatrice. Incorporer de nouvelles drogues dans les prescriptions de chimiothérapie adjuvante ou néoadjuvante peut ouvrir de nouvelles perspectives dans le traitement du cancer gastrique à modalités multiples.

Resumen

Los estudios controlados y randomizados que emplean la cirugía sola como método de control de la quimioterapia adyuvante en el cáncer gástrico han sido revisados en forma exclusiva. La cantidad de tumor residual luego de la cirugía, la selección de los regimenes de droga antineoplásica el cumplimiento en la administración de la droga y el diseño del ensayo clínico, parecen ser los factores responsables del éxito de la quimioterapia adyuvante. Aunque sólo existen pocos regímenes que hayan demostrado beneficio con significación estadística, el MMC único, la combinación de 5-FU y Metil-CCNU, el MFC y el FAM, parecen poseer un beneficio potencial de sobrevida en los grupos de pacientes sometidos a cirugía curativa. La incorporación de nuevas drogas a la quimioterapia adyuvante o neoadyuvante podría abrir un nuevo aspecto en la terapia multimodal en el cáncer gástrico.

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  1. Division of Gastrointestinal Tract Surgery, Cancer Institute Hospital, Tokyo, Japan

    Toshifusa Nakajima M.D.

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  1. Toshifusa Nakajima M.D.
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Nakajima, T. Review of adjuvant chemotherapy for gastric cancer. World J. Surg. 19, 570–574 (1995). https://doi.org/10.1007/BF00294725

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