Purpose: Gastric cancer is usually diagnosed in advanced stage. Chemotherapy has limited efficacy in advanced gastric cancer.
Patients and Materials and Methods: Ninety-six advanced gastric cancer patients who had been given a palliative chemotherapy in Erciyes University Medical Faculty were evaluated retrospectively.
Results: Fourty-three patients (44.8%) had palliative surgery (34 total gastrectomy, 9 subtotal gastrectomy), 56 had adenocarcinoma, 37 had signet ring cell carcinoma and 3 had mucinous adenocarcinoma. Twenty-five patients (26.0%) were treated with 5 fluorouracil (5-FU) 425 mg/m2 for 5 days and folinic acid 20 mg/m2 for 5 days every 4 week for 6 cycles (FUFA); 19 patients (19.8%) were given 5 FU 400 mg/m2 every week during 6 months (Weekly FU); 41 patients (42.7%) were treated with 5 FU 600 mg/m2 days 1,8,29,36, doxorubucin 30 mg/m2 days 1,29 and mitomycin 10 mg/m2 day 1 every 8 week for 6 cycles (FAM) and 11 patients (11.5%) had one of other chemotherapy protocols. Median progression free survival (PFS) in all patients was calculated as 9.0±1.64 months (95% CI 5.79-12.21) and overall survival (OS) was 12.0±3.13 months (95% CI 5.87-18.13). The two year PFS rate was 12.4% and OS rate was 20.8%. There was no statistically significant difference in terms of survival between chemotherapy regimens. PFS and OS seemed better in the first year in patients who had palliative surgery but this difference disappeared in the following years.
Conclusion: Chemotherapy regimens have limited activity in advanced gastric cancer. More effective chemotherapy regimens are therefore needed in the light of further investigations.

Amaç: Mide kanseri genellikle ileri evrede tanınmaktadır. 'leri evre mide kanserinde kemoterapi sınırlı etkinliğe sahiptir.
Hastalar ve Yöntem: Erciyes Üniversitesi Hastanesinde palyatif kemoterapi uygulanan 96 ileri evre mide kanseri olgusu retrospektif olarak değerlendirildi.
Bulgular: Hastalardan 43'ü (%31.5) palyatif amaçlı cerrahi girişim geçirmişti (34 total gastrektomi, 9 subtotal gastrektomi). Hastaların 56'si adenokarsinom, 37'si taslı yüzük hücreli karsinom ve 3'ü müsinöz adenokarsinomdu. Yirmi beş hasta (%26.0) 4 haftada bir 6 kür 5 fluorouracil (5-FU) 425 mg/m2 1-5 gün ve folinik asid 20 mg/m2 1-5 gün, (FUFA), 19 hasta (%19.8) altı ay süreyle her hafta 5 FU 400 mg/m2 (Haf FU), 41 hasta (% 42.7) 6 haftada bir 6 kür 5 FU 600 mg/m2 1,8,29,36. gün, doksorubisin 30 mg/m2 1,29. gün ve mitomisin 10 mg/m2 1. gün (FAM) ve 11 hasta (%11.5) diger kemoterapi rejimleri ile tedavi edildiler. Tüm hastalarda hesaplanan median progresyonsuz sağkalım 9.00±1.64ay (%95 GA 5.79-12.21) ve toplam yaşam süresi 12.00±3.13ay (%95 GA 5.87±18.13) olarak bulundu. 'ki yıllık progresyonsuz sağkalım oranı %12.4 ve toplam yaşam oranı %20.8 olarak bulundu. Kemoterapi kolları arasında sağkalım açısından anlamlı fark yoktu. Palyatif cerrahi girişim geçiren hastalarda ilk yılda daha iyi progresyonsuz ve toplam sağkalım gözlenirken bu farkın sonradan kaybolduğu görüldü.
Sonuç: Metastatik mide kanserinde kemoterapi sınırlı etkinliğe sahiptir. Çalışmalar yeni ve daha etkili kemoterapi rejimleri bulma yönünde olmalıdır.