Survival is very poor with all available single and combined approaches to treatment, although an occasional patient might have a remission lasting several months or even a few years.
• All patients with recurrent stomach cancer should be considered candidates for Phase I and Phase II clinical
trials testing anticancer drugs or biologicals. New agents such as triazinate and cisplatin analogues are being
developed. There are also investigational programs using complex drug combinations and sequences
(pharmacologic modulation).
• Standard treatment options are palliative chemotherapy with 5-FU , FAM, EAP, ELF, FAP, ELFI, and
FAMtx.
• For the patient with either local disease that couldn't be removed or local recurrent or residual disease after
surgery, the use of radiation therapy in combination with chemotherapy has been considered the best palliative
treatment, not only in helping to prevent and occasionally relieve an obstruction but also in reducing and
controlling pain. This treatment has had no major benefits for survival, however.
One study of patients treated with 3,500 to 4,000 cGy with or without intravenous 5-FU during the first
three days of radiation therapy showed an average survival of 12 months for the combination therapy versus
5.9 months for radiation therapy alone. The radiation therapy group had no five-year survivals, while 12
percent of the patients with the combination survived five years. Another study showed a combination of
radiation therapy and methyl-CCNU + 5-FU had a disease-free interval of more than four years, which exceeds
