Gastric Cancer

, Volume 12, Supplement 1, pp 10–15 | Cite as

Adjuvant chemotherapy with 5-FU or regimens including oral fluoropyrimidine for curable gastric cancer

  • Mitsuru Sasako
Review Article

Abstract

Since 2000, several studies have reported positive results in reasonable-size randomized controlled trials of adjuvant treatment for potentially curable gastric cancer. At present, postoperative adjuvant chemoradiotherapy and perioperative chemotherapy are the standard of care in the United States and Europe (including Great Britain), respectively, while postoperative S-1 monotherapy is the standard of care in Japan. The effect of adjuvant treatment varies according to the type of surgery, and the best results so far have been observed in the adjuvant chemotherapy of TS-1 for gastric cancer (ACTS-GC) trial, in which D2 surgery followed by S-1 monotherapy was tested. The role of radiotherapy after D2 dissection remains unclear.

Key words

Adjuvant treatment Fluorouracil Chemoradiotherapy Gastric cancer 

References

  1. 1.
    Oba K, Morita S, Tsuburaya A, Kodera Y, Kobayashi M, Sakamoto J. Efficacy of adjuvant chemotherapy using oral fluorinated pyrimidines for curatively resected gastric cancer: a metaanalysis of centrally randomized controlled clinical trials in Japan. J Chemother 2006;18:311–317.PubMedGoogle Scholar
  2. 2.
    Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725–730.PubMedCrossRefGoogle Scholar
  3. 3.
    Cunningham D, Allum WH, Stenning SP, Thompson JN, van de Velde CJH, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006;355:11–20.PubMedCrossRefGoogle Scholar
  4. 4.
    Neri B, Andreoli F, Boffi B, Francesconi D, Mazzanti R, Medi F, et al. Randomized trial of adjuvant chemotherapy versus control after curative resection for gastric cancer: 5-year follow up. Br J Cancer 2001;84:878–880.PubMedCrossRefGoogle Scholar
  5. 5.
    Neri B, de Leonardis V, Romano S, Andreoli F, Pernice LM, Bruno L, et al. Adjuvant chemotherapy after gastric resection in node-positive cancer patients: a multicentre randomised study. Br J Cancer 1996;73:549–552.PubMedGoogle Scholar
  6. 6.
    Bajetta E, Buzzoni R, Mariani L, Beretta E, Bozzetti F, Bordogna G, et al. Adjuvant chemotherapy in gastric cancer: 5-year results of a randomized study by the Italian Trials in Medical Oncology (ITMO) Group. Ann Oncol 2002;13:299–307.PubMedCrossRefGoogle Scholar
  7. 7.
    Chipponi J, Hugier M, Pezet D, Basso N, Hay JM, Quandalle P, et al. Randomized trial of adjuvant chemotherapy after curative resection for gastric cancer. Am J Surg 2004;187:440–445.PubMedCrossRefGoogle Scholar
  8. 8.
    Bouché O, Ychou M, Burtin P, Bedenne L, Ducreux M, Lebreton M, et al. Adjuvant chemotherapy with 5-fluorouracil and cisplatin compared with surgery alone for gastric cancer; 7-year results of the FFCD randomized phase III trial (8801). Ann Oncol 2005;16:1488–1497.PubMedCrossRefGoogle Scholar
  9. 9.
    Nitti D, Wils J, Dos Santos JG, Fountzilas G, Conte PF, Sava C, et al. Randomized phase III trials of adjuvant FAMTX or FEMTX compared with surgery alone in resected gastric cancer. A combined analysis of the EORTC GI Group and the ICCG. Ann Oncol 2006;17:262–269.PubMedCrossRefGoogle Scholar
  10. 10.
    De Vita F, Giuliani F, Orditura M, Galizia G, Di Martino N, Montemurro F, et al. Adjuvant chemotherapy with epirubicin, leucovorin, 5-fluorouracil and etoposide regimen in resected gastric cancer patients: a randomized phase IIItrial by the Gruppo Oncologico Italia Meridionale (GOIM 9602 Study). Ann Oncol 2007;18:1354–1358.PubMedCrossRefGoogle Scholar
  11. 11.
    Nakajima T, Nashimoto A, Kitamura M, Kito T, Iwanaga T, Okabayashi K, et al. Adjuvant mitomycin and fluorouracil followed by oral uracil plus tegafur in serosa-negative gastric cancer: a randomized trial. Lancet 1999;354:273–277.PubMedCrossRefGoogle Scholar
  12. 12.
    Nashimoto A, Nakajima T, Furukawa H, Kitamura M, Kinoshita T, Yamamura Y, et al. Randomized trial of adjuvant chemotherapy with mitomycin, fluorouracil, and cytosine arabinoside followed by oral fluorouracil in serosa-negative gastric cancer; Japan Clinical Oncology Group 9206-1. J Clin Oncol 2003;21:2282–2287.PubMedCrossRefGoogle Scholar
  13. 13.
    Miyashiro I, Furukawa H, Sasako M, Yamamoto S, Nashimoto A, Nakajima T, et al. No survival benefit with adjuvant chemotherapy for serosa-positive gastric cancer: randomized trial of adjuvant chemotherapy with cisplatin followed by oral fluorouracil (UFT) in serosa-positive gastric cancer. Presented at the 2005 Gastrointestinal Cancers Symposium; 2005 January 27–29; Hollywood, FL, USA. Alexandria, VA, American Society of Clinical Oncology; 2005.Google Scholar
  14. 14.
    Nakajima T, Kinoshita T, Nashimoto A, Sairenji M, Yamaguchi T, Sakamoto J, et al. Randomized controlled study of adjuvant uracil-tegafur versus surgery alone for serosa-negative, locally advanced gastric cancer. Br J Surg 2007;94:1468–1476.PubMedCrossRefGoogle Scholar
  15. 15.
    Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 2007;357:1810–1820.PubMedCrossRefGoogle Scholar
  16. 16.
    McCulloch PG, Ochiai A, O’Dowd GM, Nash JR, Sasako M, Hirohashi S. Comparison of the molecular genetics of c-erb-B2 and p53 expression in stomach cancer in Britain and Japan. Cancer 1995;75:920–925.PubMedCrossRefGoogle Scholar
  17. 17.
    Bonenkamp JJ, van de Velde CJ, Kampschöer GH, Hermans J, Hermanek P, Bemelmans M, et al. Comparison of factors influencing the prognosis of Japanese, German, and Dutch gastric cancer patients. World J Surg 1993;17:410–415.PubMedCrossRefGoogle Scholar
  18. 18.
    Bunt AMG, Hermans J, Smit VT, van de Velde CJ, Fleuren GJ, Bruijn JA. Surgical/pathological stage migration confounds comparisons of gastric cancer survival rates between Japan and western countries. J Clin Oncol 1995;13:19–25.PubMedGoogle Scholar
  19. 19.
    Macdonald JS, Smalley S, Benedetti J, Estes N, Haller D, Ajani JA, et al. Presented at the 2004 Gastrointestinal Cancers Symposium; 2004 Jan 22–24; San Francisco, CA, USA. Alexandria, VA, American Society of Clinical Oncology; 2004.Google Scholar
  20. 20.
    Hundahl SA, Macdonald JS, Benedetti JB, Fitzsimmons T. Surgical treatment variation in a prospective randomized trial of chemoradiotherapy in gastric cancer: the effect of undertreatment. Ann Surg Oncol 2002;9:278–286.PubMedCrossRefGoogle Scholar
  21. 21.
    Kim SK, Lim DH, Lee JY, Kang WK, Macdonald JS, Park CH, et al. An observational study suggesting clinical benefit for adjuvant postoperative chemoradiotherapy in a population of over 500 cases after gastric resection with D2 nodal dissection for adenocarcinoma of the stomach. Int J Radiat Oncol Biol Phys 2005;63:1279–1285.PubMedCrossRefGoogle Scholar

Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2009

Authors and Affiliations

  • Mitsuru Sasako
    • 1
  1. 1.Department of SurgeryHyogo College of MedicineHyogoJapan

Personalised recommendations