Advanced Gastric Carcinoma Chemotherapy with Cisplatin, Mitomycin C, BCNU, and 5-Fluorouracil in Combination

Forty patients with advanced gastric carcinoma were treated with mitomycin C, BCNU, cisplatin, and 5-fluorouracil in combination. Mitomycin C 6 mg per sq m was given by i.v. on day 1, BCNU 60 mg per sq m was given by i.v. on day 2, cisplatin 60 mg per sq m was given by 3 hour i.v. infusion with mannitol diuresis on day 3, and 5-fluorouracil 300 mg per sq m was given by i.v. infusion on days 4, 5, and 6. Each course of the polychemotherapy was repeated every 35 days. Two patients failed to return for follow-up, thus 38 patients were available for response evaluation of this regimen. Of the 38 patients, 25 (66%) achieved partial remission. The median duration of response was 20 weeks. Survival time was not measured. Significant bone marrow toxicities were not encountered. The major toxic side effects were gastrointestinal: anorexia, nausea and/or vomitings. Clinically significant ototoxicity or nephrotoxicity was not experienced. One patient developed a mild peripheral neuropathy. This four-drug polychemotherapy regimen appears to have substantial activity agaist advanced gastric carcinoma.