Adjuvant chemotherapy (ECF regimen) for patients with gastric adenocarcinoma

ECF is an active regimen in advanced gastric adenocarcinoma (GAC). We used ECF as an adjuvant therapy in a cohort of patients with GAC who underwent curative surgery and describe their results in terms of feasibility and outcome.

Forty-seven patients with locally advanced GAC underwent curative surgery followed by 4 to 6 courses of adjuvant ECF. Their median age was 59 years (range 32-74) and UICC stage was III-IV in 28 patients (59%). Partial or total gastrectomy was performed in 49% and 47% of cases, respectively.

Chemotherapy was well tolerated, the main grade 3/4 toxicities being neutropenia (47%) without severe infections, and anorexia (11%). Port adverse events were recorded in 17%. There where no treatment-related deaths. With a median follow-up of 65 months, the median overall- and relapse-free survivals were 50.1 months and 42.6 months, respectively.

The adjuvant ECF regimen is safe and feasible in resected patients with locally advanced GAC. The survival in our series compares favorably with cohorts described by others, supporting our confidence on using adjuvant ECF for patients who decide to undertake such type of treatment. ECF might be a reasonable treatment arm to be used in randomized trials of adjuvant chemotherapy.