Cancer Res Treat. 2011;43(3):154-159 of advanced gastric cancer in Korea. However, one prospective study involving oxaliplatin/5-FU/FA as first-line chemotherapy in Korean patients with advanced gastric cancer has been conducted [21]. In that study, all 37 patients were elderly ( 65 years of age). The objective of our study was to assess the efficacy and toxicity of a biweekly combination of oxaliplatin (100 mg/m2 in a 2-hour infusion), FA (200 mg/m2 in a 2-hour infusion), and 5-FU (2,400 mg/m2 in a 46-hour continuous infusion) as first-line treatment for treating younger patients with advanced gastric cancer in Korea. Although our study was retrospective, the results showed that the chemotherapy regimen was an effective and safe combination for advanced gastric cancer as first- line treatment in Korea, as well as Western countries. The OS of 9.8 months was within the range of previous trials (7-12 months) using platinum-containing and taxane- or irinotecan-based regimens. Although survival is not a reliable point for evaluation of efficacy in a retrospective study, the median survival of 9.8 months in the current study compared favorably with previous studies [3]. The treatment compliance for this regimen was good, with a dose adherence to both oxaliplatin and 5-FU of 85%. Owing to the patient selection bias, a comparison of the toxicity profiles in this study with other phase II studies that used various oxaliplatin and 5-FU administration schedules is not relevant. Compared with previous biweekly regimens [15-17], the biweekly protocol in the current study used higher levels of oxali- platin (100 mg/m2 vs. 85-100 mg/m2), and lower levels of FA (200 mg/m2 vs. 400-500 mg/m2) and 5-FU (2.4 g/m2 vs. 2.4-3.0 g/m2). In the current study, major grade 3/4 hematologic toxicity, including neutropenia (30.8%) and thrombocytopenia (20.0%), was encountered. Although we infused 5-FU continuously without bolus to reduce he- matologic toxicity, the rates of grade 3/4 neutropenia and thrombo- cytopenia were relatively high compared with other studies [16,18,19]. It is possible that the rate of hematologic toxicity reflected the relatively high dose of oxaliplatin; however, to make such an assumption, more evidence should be provided, such as 85 mg/m2 vs. 100 mg/m2 of oxaliplatin in Caucasian and Asian populations. Nevertheless, the toxi- R e f e r e n c e s 1. Pisters PW, Kelsen DP, Powell SM, Tepper JE. Cancer of the stomach. In: De Vita VT Jr, Hellman S, Rosenberg SA, editors. Cancer: principles and practice of oncology. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005. p. 909-44. 2. Glimelius B, Ekström K, Hoffman K, Graf W, Sjödén PO, Haglund U, et al. Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol. 1997;8:163-8. 3. Ohtsu A. 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Eur J Cancer. 2003;39:112-9. 158 CANCER RESEARCH AND TREATMENT cities were manageable. Neurotoxicity is the most common side effect in an oxaliplatin-containing protocol, but there was no grade 3/4 neuro- toxicity encountered during the current study, which may have been due to the relatively low cumulative dose of oxaliplatin (median, 521 mg/m2) used in this setting; indeed, neuropathy is particularly prevalent for cumulative doses 540 mg/m2 [22]. One female patient had acute renal failure after one treatment cycle requiring transient hemodialysis; she had normal renal function before treatment and did not receive me- dications with renal toxicity. Further, she declined continuation of treat- ment for voluntary withdrawal after one cycle. Therefore, the investi- gator considered renal toxicity a possible untoward effect related to oxaliplatin [16]. In the current study, diarrhea occurred in 6.7% of the cycles, but 46.2% of the cycles had associated constipation (grade 1 or 2). 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Phase III trial in metastatic gastroesophageal adenocarcinoma with fluorouracil, leucovorin plus either oxaliplatin or cisplatin: a study of the Arbeitsgemeinschaft