Boku Narikazu, Ohtsu Atsushi, Yoshida Shigeaki, Shirao Kuniaki, Shimada Yasuhiro, Hyodo Ichinosuke, Saito Hiroshi, Miyata Yoshinori
Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
Jpn J Clin Oncol. 2007 Apr;37(4):275-81. doi: 10.1093/jjco/hym015. Epub 2007 May 23.
Our previous phase II study of 5-fluorouracil (5-FU) and cisplatin (FP) for treatment of advanced gastric cancer showed that strong immunoreactivity for vascular endothelial growth factor (VEGF) is associated with chemoresponse. Patients with four or five of the favorable phenotypes, p53 (-), bcl-2 (-), gluthathione S-transferase pi (-), thymidylate synthase (-), and VEGF (+), survived longer than those with three or less of these phenotypes. The purpose of this study is to confirm our previous results and to compare the significance of those markers between continuous infusion of 5-FU (5-FUci) and FP.
Pretreatment biopsies from 131 of 210 advanced gastric cancer patients enrolled to JCOG9205 were analyzed immunohistochemically for the presence of the five markers.
Median survival times of patients treated with 5-FUci (n = 65) or FP (n = 66) were 216 and 253 days, respectively (P = 0.6953). After FP treatment, patients with four or five favorable phenotypes (n = 20) survived longer than those with three or less favorable phenotypes (n = 46) (334 days and 243 days, respectively; P = 0.0463), and the survival times of 34 and 32 patients with VEGF (-) and (+) were similar (269 days and 253 days, respectively; P = 0.6317). After 5-FUci, 30 patients with VEGF (+) survived for a shorter time than 35 patients with VEGF (-) (142 days and 302 days, respectively; P = 0.0043).
The number of favorable phenotypes is prognostic for gastric cancer patients treated with FP, and VEGF has a different impact on survival between treatment with 5-FUci and FP.
我们之前进行的一项关于5-氟尿嘧啶（5-FU）和顺铂（FP）治疗晚期胃癌的II期研究表明，血管内皮生长因子（VEGF）的强免疫反应性与化疗反应相关。具有四种或五种有利表型（p53（-）、bcl-2（-）、谷胱甘肽S-转移酶pi（-）、胸苷酸合成酶（-）和VEGF（+））的患者比具有三种或更少这些表型的患者存活时间更长。本研究的目的是证实我们之前的结果，并比较持续输注5-FU（5-FUci）和FP之间这些标志物的意义。
对纳入JCOG9205研究的210例晚期胃癌患者中的131例进行预处理活检，免疫组化分析这五种标志物的存在情况。
接受5-FUci治疗的患者（n = 65）和接受FP治疗的患者（n = 66）的中位生存时间分别为216天和253天（P = 0.6953）。接受FP治疗后，具有四种或五种有利表型的患者（n = 20）比具有三种或更少有利表型的患者（n = 46）存活时间更长（分别为334天和243天；P = 0.0463），VEGF（-）和（+）的34例和32例患者的生存时间相似（分别为269天和253天；P = 0.6317）。接受5-FUci治疗后，30例VEGF（+）患者的存活时间比35例VEGF（-）患者短（分别为142天和302天；P = 0.0043）。
有利表型的数量对接受FP治疗的胃癌患者具有预后意义，并且VEGF在5-FUci和FP治疗之间对生存有不同影响。
