Department of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Gastric Cancer. 2010 Aug;13(3):149-54. doi: 10.1007/s10120-010-0548-1. Epub 2010 Sep 5.
A multicenter phase II study was conducted to evaluate the efficacy and safety of a combination regimen of weekly paclitaxel plus S-1 in patients with advanced gastric cancer.
Patients with previously untreated metastatic or recurrent gastric cancer received intravenous paclitaxel 50 mg/m(2) on days 1, 8, and 15, plus oral S-1 40 mg/m(2) b.i.d. on days 1 to 14 followed by 2 weeks off, in a 28-day cycle.
A total of 54 patients were registered. All of them had measurable disease and were determined to be eligible for the present study. Two complete responses and 23 partial responses were confirmed, giving an overall response rate of 46.3%. At a final follow up of 3 years, the median progression-free survival and median overall survival were 6.0 and 14.3 months, respectively. Grade 3 neutropenia occurred in 14 patients, and grade 4 in 1 patient (total, 27.8%). The most serious nonhematological toxicity was diarrhea, where grade 3 occurred in 5 patients (9.3%). There were no treatment-related deaths.
A combination of weekly paclitaxel plus S-1 was found to be well tolerated and effective in patients with advanced gastric cancer. Further investigation with comparative trials is needed for confirmation.
一项多中心 II 期研究评估了每周紫杉醇联合 S-1 方案治疗晚期胃癌的疗效和安全性。
未经治疗的转移性或复发性胃癌患者接受静脉注射紫杉醇 50mg/m2,第 1、8 和 15 天,联合口服 S-1 40mg/m2,每日 2 次,第 1 天至第 14 天,然后停药 2 周,每 28 天为一个周期。
共登记了 54 例患者。所有患者均有可测量的疾病,并被确定符合本研究的条件。确认了 2 例完全缓解和 23 例部分缓解,总缓解率为 46.3%。在 3 年的最终随访中,中位无进展生存期和中位总生存期分别为 6.0 个月和 14.3 个月。14 例患者发生 3 级中性粒细胞减少症,1 例患者发生 4 级中性粒细胞减少症(总发生率为 27.8%)。最严重的非血液学毒性是腹泻,其中 5 例患者(9.3%)为 3 级。无治疗相关死亡。
每周紫杉醇联合 S-1 方案治疗晚期胃癌耐受性良好,疗效确切。需要进一步进行比较试验的研究以确认。