Combination of chemotherapy and interventional management for the treatment of advanced gastric cancer: comparison study of different chemotherapy routes

Objective: To explore the safety and efficacy of chemotherapy through different routes combined with interventional management in treating advanced gastric cancer. Methods: A total of 60 patients with gastroscopy-and biopsy-proved gastric adenocarcinoma were enrolled in this study. The patients were randomly and equally divided into group A (n = 30) and group B (n = 30). EOF scheme of chemotherapy, i.e. 5-Fu 500 mg/m², epirubicin 40-60 mg and oxaliplatin 130 mg/m², was employed in all patients for interventional management. Then patients in group A received intravenous chemotherapy (CF 150 mg/m² lasting for 2 hours and 30 minutes later 5-Fu 500 mg/m² lasting for 6 hours), which was carried out during the 1st to the 4th day after the intervention, and every four weeks constituted a single therapeutic course. Patients in group B received oral chemotherapy (tegafur 40-60 mg two times per day) during the 8th to the 21st day after the intervention. After one week the next course of oral chemotherapy was repeated. The adverse effects and Kaplan-Merier survival curves were compared between the two groups. Results: At least two courses of treatment were accomplished in each patient. Significant differences in aleukocytosis, thrombocytopenia, nausea and vomiting existed between the two groups (P < 0.05), while no significant difference in Kaplan-Merier survival curves existed between the two groups (P = 0.625). Conclusion: Oral administration of tegafur is superior to systemic intravenous chemotherapy with 5-Fu in treating advanced gastric cancer when interventional therapy is employed together. The oral administration of tegafur is safer, and the patient's life quality can be markedly improved. (authors)