[Combined chemotherapy with the FEM protocol in advanced gastric cancer]

Thirty one patients with diagnosis of Gastric Cancer were admitted in this study. Median age was 71 years (range 24-82). Twenty two were male. No one had previous chemotherapy. Functional capacity was 0-1 in 26/31 (60.6%). More common symptoms were: loss of weight 21/31 (75.1%) and abdominal pain in 13/31 (40.3%). Ten patients were Borrmann III and nine Borrmann IV. Twenty one had surgery: 12 palliative gastrectomy and 9 exploratory laparatomy. Twenty three cases were adenocarcinoma and 8 undifferentiated carcinoma. FEM regimen was administered (5 Fluoruracil 600 mg/m2/day 1 and 8, Epidoxorubicin 30 mg/m2/day 1 and Mitomycin 10 mg/m2/day 1). Ten of 24 patients (41.7%) achieved partial remission with a median survival of 10.5 months. Three patients achieved subjective response with a median survival of 6 months. Median survival for the non response was 3 months (range 2-7 months). Survival difference between responders and no responders was statistically significant. Survival among the adjuvent group was 5.7 months (range 2-16 months). One out of three patients survived without evidence of disease at the end of this study. Twenty three patients died and 5 were lost to follow up. Alopecia was the most common secondary effect in 74%, nausea and vomiting in 60% and leukopenia below 3000 x mm3 in 54%. Cardiotoxicity was not documented in any case.