20007
document
Efficiency of adjuvant immunochemotherapy following curative resection in patients with locally advanced gastric cancer . BACKGROUND Despite curative resection , 50 % -90 % of gastric cancer patients die of disease relapse . Although some clinical trials have indicated that chemotherapy and immunochemotherapy may be effective modalities , more recent studies have not been able to define the standard treatment for advanced gastric cancer . The present study evaluated the effect of adjuvant immunochemotherapy with the use of BCG ( bacille Calmette-Guerin ) and FAM ( 5-fluorouracil , adriamycin , mitomycin C ) chemotherapy on the survival of patients with locally advanced resectable gastric cancer . METHODS A total of 156 patients with stage III or IV gastric cancer who had undergone curative resection were randomly assigned to three treatment groups : BCG + FAM ( immunochemotherapy ) , FAM ( chemotherapy ) , and control ( surgery only ) . Treatment was continued for 2 years or until death . Further postsurgical follow up was carried on for up to 10 years . RESULTS Overall 10-year survival was 47.1 % for the immunochemotherapy group ( P < 0.037 vs FAM and P < 0.0006 vs control ) , 30 % for the chemotherapy group ( vs control , NS ) , and 15.2 % for the control group . In patients with pT2/T3 primary tumors , 10-year survival was 55.3 % for BCG + FAM vs 28.2 % for FAM ( P < 0.01 ) and 14.6 % for the control group ( P < 0.00018 ) . BCG + FAM significantly improved the survival of patients with intestinal-type but not diffuse-type cancer . Immunochemotherapy was well tolerated . CONCLUSION This study , based on a limited number of patients , indicates that adjuvant immunochemotherapy ( BCG + FAM ) may prolong the survival of gastric cancer patients after curative gastrectomy ; in particular , in patients with pT2/T3 tumors and intestinal-type primary tumors . There was no survival benefit from FAM adjuvant chemotherapy .
20008
Intervention_Physical
Efficiency of adjuvant immunochemotherapy
20009
Intervention_Physical
adjuvant immunochemotherapy with the use of
20010
Intervention_Pharmacological
BCG ( bacille Calmette-Guerin )
20011
Intervention_Pharmacological
FAM
20012
Intervention_Pharmacological
5-fluorouracil
20013
Intervention_Pharmacological
adriamycin
20014
Intervention_Pharmacological
mitomycin C
20015
Intervention_Pharmacological
chemotherapy
20016
Intervention_Pharmacological
randomly assigned to three treatment groups : BCG + FAM
20017
Intervention_Pharmacological
immunochemotherapy
20018
Intervention_Pharmacological
chemotherapy
20019
Intervention_Surgical
control ( surgery only )
20020
Intervention_Surgical
Further postsurgical follow up was carried on for up to 10 years
20021
Intervention_Physical
FAM
20022
Intervention_Physical
chemotherapy
20023
Intervention_Physical
BCG + FAM
20024
Outcome_Other
Efficiency
20025
Outcome_Physical
disease relapse
20026
Outcome_Mortality
survival of patients
20027
Outcome_Mortality
10-year survival
20028
Outcome_Mortality
10-year survival
20029
Outcome_Mortality
survival of patients
20030
Outcome_Mortality
survival
20031
Outcome_Mortality
survival benefit
20032
Participant_Condition
gastric cancer .
20033
Participant_Condition
gastric cancer
20034
Participant_Condition
gastric cancer .
20035
Participant_Condition
resectable gastric cancer .
20036
Participant_Sample-size
156
20037
Participant_Condition
stage III or IV gastric cancer
20038
Participant_Condition
curative resection
20039
Participant_Condition
pT2/T3 primary tumors
20040
Participant_Condition
intestinal-type but not diffuse-type cancer .
20041
Participant_Condition
gastric cancer
20042
Participant_Condition
curative gastrectomy
20043
Participant_Condition
pT2/T3 tumors and intestinal-type primary tumors .