Impact of modified FOLFOX-6 for patients with gastric cancer and a gastrointestinal obstruction

Asia Pac J Clin Oncol. 2019 Oct;15(5):e91-e96. doi: 10.1111/ajco.13110. Epub 2018 Dec 13.

Abstract

Aim: Gastric cancer patients are normally treated with oral fluoropyrimidine and cisplatin or oxaliplatin; however, treating patients who also have a gastrointestinal obstruction is often difficult because of their poor oral intake. Instead, a modified (m)FOLFOX-6 regimen is administered, even to patients with gastrointestinal obstructions. The aim of this study was to assess the efficacy of mFOLFOX-6 for gastric cancer patients with a gastrointestinal obstruction.

Methods: Patients with a poor oral intake because of a gastrointestinal obstruction who received mFOLFOX-6 as systemic chemotherapy were retrospectively analyzed. Poor oral intake was defined as receiving a daily intravenous drip infusion due to a gastrointestinal obstruction.

Results: Eighteen patients received mFOLFOX-6; the median progression-free survival was 6.8 months (95% confidence interval [CI], 1.9-9.7), the median overall survival was 8.0 months (95% CI, 2.8-20.8) and the median time to treatment failure was 2.2 months (95% CI, 1.2-5.7). An improved oral intake was observed in 13 of the 18 treated patients, with 12 of these continuing treatment as outpatients.

Conclusions: A mFOLFOX-6 treatment regimen seems promising for gastric cancer patients who have a gastrointestinal obstruction.

Keywords: gastric cancer; gastrointestinal obstruction; mFOLFOX.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Female
  • Fluorouracil / administration & dosage
  • Gastrointestinal Neoplasms / drug therapy*
  • Gastrointestinal Neoplasms / pathology
  • Humans
  • Intestinal Obstruction / drug therapy*
  • Intestinal Obstruction / pathology
  • Leucovorin / administration & dosage
  • Male
  • Middle Aged
  • Oxaliplatin / administration & dosage
  • Retrospective Studies
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / pathology
  • Survival Rate
  • Treatment Outcome

Substances

  • Oxaliplatin
  • Leucovorin
  • Fluorouracil