Abstract

The postoperative adjuvant chemotherapy with FAM combination chemotherapy has been administered to 167 patients with stage IB, II, IIIA or IIIB gastric adenocarcinoma after cura- tive gastric resection between March l984 and December 1986. Chemotherapy was started within 4 weeks of surgery in most patiente. Treatment consisted of 5-FU 600 mg/m(2) (day 1, 8, 29 and 36), adriamycin 30 mg/m(2) (day l and 29), mitomycin-C 10 mg /m(2) (day 1) of an 8-week cycle. The cycle was repeated 3 times. Appropriate dose adjustment was made for hematologic and other toxicities. Twelve patients were ineligible for the study and excluded from the analysis. After median follow-up of 79 months, 65 of 155 treated patients recurred (41.9%). The sites of recurrent cancer were as follows: loco-regional, 35%, peritoneal, 23%, distant metastases, 23%, multiple sites, 19%. The 5-year disease-free survival rate was 57.1% and the 5-year overall survival rate was 60.6%. Treatment was well tolerated by the majority of patients and the common side effects were nausea and vomiting (51%). Sex, N stage and the number of involved lymph nodes affect- ed disease-free and overall survival. In conclusion, the postoperative adjuvant chemotherapy with FAM combination chemotherapy was safe and well tolerated. Although the results of FAM chemotherapy were more effec- tive than those of FM chemotherapy as historical control, we concluded that adjuvant chemo- therapy as given in this trial is not indicated as routine trestment in operable gastric cancer. So new trials of adjuvant chemotherapy for gastric cancer must be prospectively randomired and include a no-treatment control arm.

• Keywords: Stomach cancer, Adiuvant chemotherapy, FAM