RETROSPECTIVE COMPARISON OF INFUSIONAL 5-FLUOROURACIL, DOXORUBICIN, AND MITOMYCIN-C (MODIFIED FAM) COMBINATION CHEMOTHERAPY VERSUS PALLIATIVE THERAPY IN TREATMENT OF ADVANCED GASTRIC-CANCER

About one-third of patients with gastric cancer are unresectable at th e 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. Wie retrospect ively reviewed the clinical records of 409 advanced gastric cancer pat ients who had not received curative surgery. Among 409 patients, 202 p atients were treated with an mFAM regimen (infusional 5-FU + doxoruboc in + mitomycin-C), and 207 patients received no chemotherapy (control group). No differences were found in clinical parameters between the t wo groups. The 1-year survival rates were 34.1% for the mFAM-treated g roup 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 an d palliative surgery. Of the 154 evaluable patients in the mFAM-treate d group, the response rate was 17.5%. In these patients, median respon se duration was 30 weeks. and progression free survival was 23 weeks. Overall toxicity of mFAM regimen was relatively tolerable rind reversi ble. In conclusion, FAM combination chemotherapy, which has been used as a standard therapy, prolonged survival after modification of the ad ministration schedule and combination with palliative surgery. A prosp ective randomized study is warranted to confirm this conclusion from o ur retrospective study.