Weekly etoposide, epirubicin, cisplatin, 5-fluorouracil and leucovorin: An effective chemotherapy in advanced gastric cancer

K. H. Chi, Y. Chao, W. K. Chan, S. S. Lo, S. Y. Chen, S. H. Yen, K. Y. Chen, C. W. Wu, S. D. Lee, W. Y. Lui*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

In order to optimize the therapeutic index of combining etoposide, epirubicin, cisplatin, 5-fluorouracil (5-FU), leucovorin (EEPFL) chemotherapy in the treatment of advanced gastric cancer, a trial of a novel schedule of weekly administration was conducted. Weekly EEPFL treatment consisted of a concomitant boost of etoposide 40 mg m-2 i.v. over 30 min, epirubicin 10 mg m-2 i.v. over 5 min to a backbone regimen, weekly PFL chemotherapy with cisplatin 25 mg m-2, 5-FU 2200 mg m-2, leucovorin 120 mg m-2 given simultaneously by 24-h i.v. infusion. Response, survival and toxicity were evaluated. Forty-two patients were studied. Median age was 69 (range 31-84) years. Twenty-six per cent of patients showed complete response and 45% partial response. The overall response rate was 71% (95% confidence interval 58-84%). For a total of 507 weekly EEPFL cycles delivered, the incidence of grade 4 leucopenia was 1% of cycles. One patient died of neutropenia septicaemia. There was no other grade 4 toxicity. Grade 3 and 2 leucopenia occurred in 7% and 14% of cycles. The incidence of grade 3 and 2 mucositis was 1% and 3% of cycles. Grade 3 and 2 diarrhoea occurred in 0.4% and 1.6% of cycles. Overall median survival was 10 months (range 3-41+ months). Weekly EEPFL chemotherapy is an effective regimen with tolerable toxicities in the treatment of advanced gastric cancer. A randomized controlled clinical trial to formally assess the efficacy and benefit of EEPFL chemotherapy is under way.

Original languageEnglish
Pages (from-to)1984-1988
Number of pages5
JournalBritish Journal of Cancer
Volume77
Issue number11
DOIs
StatePublished - Jun 1998

Keywords

  • 5-Fluorouracil
  • Chemotherapy
  • Cisplatin
  • Epirubicin
  • Etoposide
  • Gastric cancer
  • Leucovorin
  • Weekly administration

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