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Retrospective Comparison of Infusional 5-Fluorouracil, Doxorubicin, and Mitomycin-C (Modified FAM) Combination Chemotherapy Versus Palliative Therapy in Treatment of Advanced Gastric Cancer

 Park, Joon Oh  ;  Chung, Hyun Cheol  ;  Cho, Jae Yong  ;  Rha, Sun Young  ;  You, Nae Choon  ;  Kim, Joo Hang  ;  Noh, Sung Hoon  ;  Kim, Choong Bai  ;  Min, Jin Sik  ;  Kim, Byung Soo  ;  Roh, Jae Kyung 
 American Journal of Clinical Oncology, Vol.20(5) : 484-489, 1997 
Journal Title
 American Journal of Clinical Oncology 
Issue Date
Adenocarcinoma/drug therapy* ; Adenocarcinoma/surgery ; Adolescent ; Adult ; Aged ; Antibiotics, Antineoplastic/administration & dosage* ; Antibiotics, Antineoplastic/adverse effects ; Antimetabolites, Antineoplastic/administration & dosage* ; Antimetabolites, Antineoplastic/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Disease Progression ; Doxorubicin/administration & dosage* ; Doxorubicin/adverse effects ; Drug Administration Schedule ; Female ; Fluorouracil/administration & dosage* ; Fluorouracil/adverse effects ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Mitomycin/administration & dosage* ; Mitomycin/adverse effects ; Palliative Care* ; Prognosis ; Prospective Studies ; Randomized Controlled Trials as Topic ; Remission Induction ; Retrospective Studies ; Stomach Neoplasms/drug therapy* ; Stomach Neoplasms/surgery ; Survival Rate ; Time Factors
About one-third of patients with gastric cancer are unresectable at the time of diagnosis. Their median survival is < 6 months, with a grave prognosis. The purpose of this study was to assess the efficacy of a modified FAM (mFAM) regimen in advanced gastric cancer. We retrospectively reviewed the clinical records of 409 advanced gastric cancer patients who had not received curative surgery. Among 409 patients, 202 patients were treated with an mFAM regimen (infusional 5-FU + doxorubocin + mitomycin-C), and 207 patients received no chemotherapy (control group). No differences were found in clinical parameters between the two groups. The 1-year survival rates were 34.1% for the mFAM-treated group and 22.5% for the control group (p = 0.0135). In subset analysis, a higher 1-year survival rate was demonstrated in patients with mFAM and palliative surgery. Of the 154 evaluable patients in the mFAM-treated group, the response rate was 17.5%. In these patients, median response duration was 30 weeks, and progression-free survival was 23 weeks. Overall toxicity of mFAM regimen was relatively tolerable and reversible. In conclusion, FAM combination chemotherapy, which has been used as a standard therapy, prolonged survival after modification of the administration schedule and combination with palliative surgery. A prospective randomized study is warranted to confirm this conclusion from our retrospective study.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Joo Hang(김주항)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Roh, Jae Kyung(노재경)
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Yoo, Nae Choon(유내춘)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Cho, Jae Yong(조재용) ORCID logo https://orcid.org/0000-0002-0926-1819
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