Yildiz Ramazan, Kalender Mehmet Emin, Dane Faysal, Sevinc Alper, Gumus Mahmut, Camci Celalettin, Alici Suleyman, Kaya Ali Osman, Yaman Emel, Ozturk Banu, Coskun Ugur, Benekli Mustafa, Uncu Dogan, Buyukberber Suleyman
Department of Medical Oncology, Gazi University Medical School, Ankara, Turkey.
J Oncol Pharm Pract. 2010 Sep;16(3):173-8. doi: 10.1177/1078155209347402. Epub 2009 Oct 15.
Platinum, antracyline, and fluoropyrimidine combination chemotherapy has been widely used as a first-line treatment for advanced gastric cancer (AGC). In the present study, we determined the efficacy and the safety of docetaxel and oral etoposide as second-line combination chemotherapy after failure of commonly used combination regimens in AGC.
Patients with histologically proven gastric cancer and measurable metastatic disease received docetaxel 75 mg/m(2) as a 1-h intravenous infusion on day 1, and oral etoposide 50 mg/m(2) once daily on days 1-5, every 3 weeks until disease progression or unacceptable toxicities.
Between June 2006 and September 2008, 32 patients, of median age 60 years (range 32-77 years) were included in the study. Overall response rate was 9.4% and 31.3% of patients achieved a stable disease. Median progression-free survival was 3 months (95% CI, 2.5-3.5). Median overall survival was 6 months (95% CI, 3.8-8.2) with 16.9% 1-year survival rate. Grade 3-4 toxicities included neutropenia (28.8%), febrile neutropenia (18.8%), thrombocytopenia (3.1%), nausea and vomiting (15.6%), diarrhea (9.4%), and mucositis (6.2%).
Docetaxel and oral etoposide combination was moderately effective and safe in appropriately selected AGC patients after failure of platinum- and fluoropyrimidine-based combination regimens.
铂类、蒽环类和氟嘧啶联合化疗已被广泛用作晚期胃癌(AGC)的一线治疗方案。在本研究中,我们确定了多西他赛和口服依托泊苷作为AGC常用联合方案失败后的二线联合化疗的疗效和安全性。
经组织学证实为胃癌且有可测量转移性疾病的患者,在第1天接受多西他赛75mg/m²静脉滴注1小时,在第1 - 5天每天口服依托泊苷50mg/m²,每3周重复一次,直至疾病进展或出现不可接受的毒性反应。
2006年6月至2008年9月,32例患者纳入研究,中位年龄60岁(范围32 - 77岁)。总缓解率为9.4%,31.3%的患者病情稳定。中位无进展生存期为3个月(95%CI,2.5 - 3.5)。中位总生存期为6个月(95%CI,3.8 - 8.2),1年生存率为16.9%。3 - 4级毒性反应包括中性粒细胞减少(28.8%)、发热性中性粒细胞减少(18.8%)、血小板减少(3.1%)、恶心和呕吐(15.6%)、腹泻(9.4%)和黏膜炎(6.2%)。
对于铂类和氟嘧啶类联合方案失败后经适当选择的AGC患者,多西他赛和口服依托泊苷联合治疗具有一定疗效且安全性尚可。