多西他赛和顺铂联合氟尿嘧啶与改良多西他赛、顺铂和 5-氟尿嘧啶作为一线治疗晚期胃癌的比较：单中心回顾性分析。
Docetaxel and Cisplatin Plus Fluorouracil compared with Modified Docetaxel, Cisplatin, and 5-Fluorouracil as first-line therapy for advanced gastric cancer: a retrospective analysis of single institution.
机构信息
Dicle University, Department of Medical Oncology, Diyarbakir, Turkey.
出版信息
Neoplasma. 2012;59(2):233-6. doi: 10.4149/neo_2012_030.
Gastric cancer is the second most common among cancer-related deaths in the world. Systemic chemotherapy for patients with gastric cancer has limited impact on overall survival. We performed a retrospective analysis of the efficacy and side effects of Docetaxel and Cisplatin Plus Fluorouracil (DCF) versus Modified-Dose Docetaxel, Cisplatin, and 5-Fluorouracil (mDCF) in the metastatic gastric cancer with first-line chemotherapy treated patients. Retrospectively were reviewed 107 locally advanced or metastatic gastric cancer patients who were treated DCF or mDCF as first-line treatment from June 2007 to August 2011 in Dicle University Hospital, Department of Medical Oncology.The DCF protocol included 75 mg/m2 docetaxel and cisplatin on day 1 and 750 mg/m2/day 5-FU infusion for 5 days, repeated every 3 weeks. The mDCF protocol included 60 mg/m² docetaxel and cisplatin on day 1 and 600 mg/m² 5-Fluorouracil continuous infusion per day on days 1-5, every 3 weeks.Patients were treated using DCF arm 85 (M: 56, F: 29), the mDCF arm 22 (M: 13, F: 9) After treatment toxicities were: Grade III-IV neutropenia (48.2% vs 13.6% p=0.003), anemia (21.2% vs 4.5% p=0.06), nausea (44.7% vs 13.6% p=0.008) and vomiting (31.8% vs 4.5%, p=0.01) was higher in the DCF arm. Other toxicities profile was similar in both groups (p>0.05). The rate of response was similar in both arm. Among patients with the DCF and mDCF arm rate complete response (10.3% vs 6.7%, p>0.05), partial response (35.3% vs 40.0%, p>0.05), stable disease (32.4% vs 33.3%, p>0.05), progressive disease (22.1% vs 20.0%, p>0.05) and overall response (45.6% vs 46.7%, p>0.05) did not have a statistically difference (p>0.05). Progression-free survival (PFS) and overall survival (OS) were more favorable in the DCF arm than mDCF arm, but the difference was not significant statistically (9.9 vs 8.6, 7.4 vs 6.5 p>0.05)In conclusion, the response rate, median PFS and median OS are similar in both arms, while the mDCF regimen are more favorable than the DCF for toxicity profile regimen in advanced gastric cancer patients who were undergoing first-line palliative treatment. Therefore, a prospective and larger clinical trials are needed.
胃癌是全球癌症相关死亡的第二大原因。对于胃癌患者，全身性化疗对总生存期的影响有限。我们对接受胃转移性癌症一线化疗的患者进行了多西他赛和顺铂联合氟尿嘧啶（DCF）与改良剂量多西他赛、顺铂和 5-氟尿嘧啶（mDCF）的疗效和副作用的回顾性分析。回顾性分析了 2007 年 6 月至 2011 年 8 月在迪亚勒大学医院肿瘤内科接受 DCF 或 mDCF 作为一线治疗的 107 例局部晚期或转移性胃癌患者。DCF 方案包括第 1 天和第 5 天给予 75mg/m2 多西他赛和顺铂，第 5 天给予 750mg/m2/天 5-氟尿嘧啶输注，每 3 周重复一次。mDCF 方案包括第 1 天给予 60mg/m2 多西他赛和顺铂，第 1 天至第 5 天给予 600mg/m2 5-氟尿嘧啶连续输注，每 3 周一次。患者接受 DCF 臂治疗 85 例（男性 56 例，女性 29 例），mDCF 臂治疗 22 例（男性 13 例，女性 9 例）。治疗后毒性反应为：III-IV 级中性粒细胞减少症（48.2%比 13.6%，p=0.003）、贫血（21.2%比 4.5%，p=0.06）、恶心（44.7%比 13.6%，p=0.008）和呕吐（31.8%比 4.5%，p=0.01）在 DCF 臂中更高。两组其他毒性特征相似（p>0.05）。两组的反应率相似。在 DCF 和 mDCF 臂的患者中，完全缓解率（10.3%比 6.7%，p>0.05）、部分缓解率（35.3%比 40.0%，p>0.05）、稳定疾病率（32.4%比 33.3%，p>0.05）、进展疾病率（22.1%比 20.0%，p>0.05）和总缓解率（45.6%比 46.7%，p>0.05）没有统计学差异（p>0.05）。DCF 臂的无进展生存期（PFS）和总生存期（OS）均优于 mDCF 臂，但差异无统计学意义（9.9 比 8.6，7.4 比 6.5，p>0.05）。总之，在接受一线姑息治疗的晚期胃癌患者中，mDCF 方案的反应率、中位 PFS 和中位 OS 与 DCF 方案相似，而在毒性特征方面优于 DCF 方案。因此，需要进行前瞻性和更大规模的临床试验。
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