목적:전이성 위암 환자들에서 1차 치료로서 투여된 oxaliplatin, 5-FU, leucovorin (FOLFOX-4) 병합화학요법의 효과와 안정성에 대하여 분석하였다. 방법: 2006년 8월부터 2009년 2월까지 조직학적으로 확진하고 절제가 불가능한 진행, 전이성 위암 환자 35명을 대상으로 의무기록을 통하여 후향적으로 조사하였다. Oxaliplatin 85 mg/m2과 leucovorin 200 mg/m2을 제1일에 2시간 동안 정주하였으며, 5-FU는 400 mg/m2을 bolus로, 600 mg/m2을 22시간 동안 지속 주입하는 방법으로 제1일과 2일에 투여하였다. 이상을 2주 간격으로 시행하였다. 반응률은 2 내지 3주기의 항암요법 시행 후 평가하였고, 부작용은 NCI CTC ver. 2.0을 기준으로 평가하였다. 결과: 총 35명 환자들의 총 생존기간 중앙값은 8.5개월(6.23-10.90개월)이었고, 반응지속기간은 4.5개월(0.38-9.75개월)이었다. 치료반응에서 완전관해는 없었고, 부분관해 19예(54.3%), 불변 13예(37.1%), 진행 3예(8.6%)였다. 전체 항암요법 298회 중 grade 3 이상의 백혈구 감소증은 5회(1.6%)였고, 호중구 감소증은 총 27회(9%)였다. Grade 3 이상의 빈혈은 4회(1.3%)였고, 혈소판 감소증은 10회(3.2%)였다. 호중구 감소증에 의한 감염이 있어 1명의 환자가 사망하였다. Grade 1-2 신경병증이 44회(14.7%)에서 나타났다. 결론: FOLFOX-4의 병합화학요법은 수술을 할 수 없는 진행성 위암 환자들에 대한 1차 요법으로 높은 반응률을 보이면서 독성이 약한 비교적 안전한 치료법이다.

Background/Aims:This study examined the efficacy and safety of oxaliplatin-5-fluorouracil-leucovorin (FOLFOX-4) combination chemotherapy as first-line treatment in patients with advanced gastric cancer. Methods:This retrospective study enrolled 35 patients diagnosed with pathologically proven surgically unresectable gastric cancer who received FOLFOX-4 combination chemotherapy between August 2006 and February 2009, using medical records. The administered dose of oxaliplatin was 85 mg/m2 for 2 hrs and leucovorin 200 mg/m2 for 2 hrs on day 1, 5-fluorouracil 400 mg/m2 as a bolus and 5-fluorouracil 600 mg/m2 for 22 hrs on days 1 and 2, every 2 weeks. The response was assessed every three cycles. Toxicity was evaluated for every course of chemotherapy according to the NCI toxicity criteria ver. 2.0. Results:The median patient age was 61 (range 27-77) years. The median overall survival was 8.50 (6.23-10.90) months and the median time to progression was 4.50 (0.38-9.75) months. With FOLFOX-4, there was no complete remission and 19 partial responses, for a response rate of 54.3%. Over 298 cycles, anemia worse than NCI toxicity grade 3 occurred in 1.3%, leukopenia in 1.6%, neutropenia in 9%, and thrombocytopenia in 3.2%. Grade 1-2 neuropathy occurred in 14.7% of the cycles. Neutropenic fever occurred in two cycles and the regimen was changed because of side effects in one cycle. Conclusions:FOLFOX-4 has a very high response rate with mild toxicity in patients with advanced gastric cancer as a first-line treatment.

Background/Aims:This study examined the efficacy and safety of oxaliplatin-5-fluorouracil-leucovorin (FOLFOX-4) combination chemotherapy as first-line treatment in patients with advanced gastric cancer. Methods:This retrospective study enrolled 35 patients diagnosed with pathologically proven surgically unresectable gastric cancer who received FOLFOX-4 combination chemotherapy between August 2006 and February 2009, using medical records. The administered dose of oxaliplatin was 85 mg/m2 for 2 hrs and leucovorin 200 mg/m2 for 2 hrs on day 1, 5-fluorouracil 400 mg/m2 as a bolus and 5-fluorouracil 600 mg/m2 for 22 hrs on days 1 and 2, every 2 weeks. The response was assessed every three cycles. Toxicity was evaluated for every course of chemotherapy according to the NCI toxicity criteria ver. 2.0. Results:The median patient age was 61 (range 27-77) years. The median overall survival was 8.50 (6.23-10.90) months and the median time to progression was 4.50 (0.38-9.75) months. With FOLFOX-4, there was no complete remission and 19 partial responses, for a response rate of 54.3%. Over 298 cycles, anemia worse than NCI toxicity grade 3 occurred in 1.3%, leukopenia in 1.6%, neutropenia in 9%, and thrombocytopenia in 3.2%. Grade 1-2 neuropathy occurred in 14.7% of the cycles. Neutropenic fever occurred in two cycles and the regimen was changed because of side effects in one cycle. Conclusions:FOLFOX-4 has a very high response rate with mild toxicity in patients with advanced gastric cancer as a first-line treatment.

Stomach neoplasms, Oxaliplatin