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Title   절제불가능한 위암환자에서 Etoposide , Adriamycin Cisplatin ( EAP ) 및 5 - Fluorouracil , Adriamycin Mitomycin ( FAM ) 복합화학요법의 치료효과에 대한 후향적 연구 ( Retrospective Study on Therapeutic Effects of Etoposide , Adriamycin , and Cisplatin ( EAP ) Versus 5 - Fluorouracil , Adria
Publicationinfo   1993 Jan; 025(06): 837-848.
Key_word   Unresectabie gastric cancer, Combination chemotherapy, FAM, EAP
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Abstract   There has been an initial widespread enthusiasm for EAP combination chemotherapy regimen in advanced gastric cancer, based on an uncontrolled phase II study, which showed higher response rate and ability to convert unresectable cases to resectable cases. But following stud- ies couldnt duplicate the same results. On the other hand, FAM combination chemotherapy has been considered as standard chemotherapy in advanced gastric cancer conventionally. The authors evaluated previously untreated 98 patients with unresectable gastric cancer which was confirmed by laparotomy, of whom 52 patients were treated with a FAM regimen from Jan. 1987 to Dec. 1988, and 46 patients were treated with a EAP regimen from Jan. 1990 to Dec. 1991 at Department of Surgery, Korea Cancer Center HospitaL The drug dosage and treatment schedules were identical to those of the original investigators. The only patients with measurable disease were evaluated for response rate. Results were as following: Of the 41 measurable lesions, the overall response rates were 27% and 32% in FAM and EAP arm. We had no complete response in the both arms. The median duration of response and survival were 6 months vs 8 months and 9 months vs 8 months, respectively in the FAM and RAP arm(P>0.1). Patients with well or moderately differentiated carcinoma and/or locally advanced gastric cancer showed a higher response rate and a longer survival time than those with poorly differentiated carcinoma and metastatic gastric cancer (p<0.05). EAP regimen caused significantly more severe leukopenia and thrombocytopenia than FAM regimen(p<0.05). Moreover, we had four(11%) treatment-related deaths in the EAP arm, due to profound sepsis during periods of severe myelosuppression. Severe nonhematologic toxicities were presented more frequently in the EAP arm(p<0.05). In conclusion, the EAP regimen for advanced gastric cancer was highly toxic and resulted in no better response rates and survival times than the FAM regimen. Our data don't support the use af EAP as standard chemotherapy for unresectable advanced gastric cancer.
저 자   김석윤(Seog Yun Kim),최동욱(Dong Wook Choi),이종인(Jong Inn Lee),백남선(Nam Sun Paik),문난모(Nan Mo Moon),김용규(Yong Kyu Kim)