The effect of the radiosensitizer razoxane was prospectively evaluated in advanced and recurrent gastric cancer. Endpoints of the study were mainly palliation, local response rates, and achievement of local control. From 1984 to 1993, razoxane (Rz) was given together with radiation therapy (R") to 28 patients. Twenty-three patients had inoperable primary, recurrent, or metastatic disease, and 5 patients received the treatment having microscopic residuals. The dose of Rz was 150 mg/Mz daily orally starting 5 days before the first irradiation. The drug was then given each radiation day until the end of treatment. The median dose of radiation was 50 (16-56) Gy in the evaluable patients. A complete follow-up was performed in all but one patient (96%). Taking all patients together, there was an 89% rate of partial responses for all measurable and evaluable tumors.
The local control rate was 64%, and the median time to an in-field recurrence was 7 months. A detailed analysis of the outcome for the various disease conditions is given.
Rapid pain relief was achieved in all but one patient. There was no case of an immediate tumor progression at the site of the irradiation. The treatment is easy to administer and was associated with a moderate toxicity. The toxicity is dependent on the volume irradiated.
In conclusion, the combination of RT and Rz is an excellent tool for palliation in gastric cancer. It seems that the combined treatment with Rz may lead to better response rates compared to results where irradiation alone was used.