Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
Int J Clin Oncol. 2013 Jun;18(3):539-46. doi: 10.1007/s10147-012-0416-6. Epub 2012 May 3.
Based on the results of the SPIRITS trial, combination chemotherapy of S-1 plus cisplatin (SP) is now considered the standard treatment for patients with advanced gastric cancer (AGC) in Japan. On the other hand, several non-Japanese studies have shown the efficacy of capecitabine plus cisplatin (XP), which has been used as the reference arm in recent global studies of AGC.
We retrospectively compared the efficacy and safety of SP and XP in first-line treatment for patients with AGC.
From August 2006 to November 2008, 26 AGC patients received XP in the context of 2 global trials (AVAGAST and ToGA), and 50 patients received SP during the same period. The objective response rate was 43.2 % in the SP group and 50 % in the XP group, with no significant difference (p = 0.62). There were also no significant differences in progression-free survival (median 5.8 vs. 5.2 months; p = 0.91) and overall survival (median 13.8 vs. 13.5 months; p = 0.97) between the SP and XP groups. The frequencies of hematological toxicities of grade 3 or more and non-hematological toxicities were not significantly different between the 2 groups. Although grade 1 or 2 hand-foot syndrome was more common in the XP group, no patients experienced grade 3 or more.
Although the retrospective nature of this study and the small number of patients is a major limitation, SP and XP were associated with similar efficacy and safety in patients with AGC.
基于 SPIRITS 试验的结果，S-1 联合顺铂（SP）化疗现在被认为是日本晚期胃癌（AGC）患者的标准治疗方法。另一方面，几项非日本的研究表明卡培他滨联合顺铂（XP）的疗效，XP 已被用于最近全球 AGC 研究的参照臂。
我们回顾性比较了 SP 和 XP 在 AGC 一线治疗中的疗效和安全性。
从 2006 年 8 月到 2008 年 11 月，26 名 AGC 患者在两项全球试验（AVAGAST 和 ToGA）中接受 XP 治疗，同期有 50 名患者接受 SP 治疗。SP 组的客观缓解率为 43.2%，XP 组为 50%，差异无统计学意义（p=0.62）。无进展生存期（中位 5.8 与 5.2 个月；p=0.91）和总生存期（中位 13.8 与 13.5 个月；p=0.97）也无显著差异。两组的血液学毒性 3 级或以上和非血液学毒性的发生率无显著差异。尽管 XP 组 1 级或 2 级手足综合征更为常见，但无患者发生 3 级或以上。
尽管本研究的回顾性和患者数量较少是一个主要限制，但 SP 和 XP 在 AGC 患者中的疗效和安全性相似。
