Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
PLoS One. 2012;7(6):e38652. doi: 10.1371/journal.pone.0038652. Epub 2012 Jun 26.
Recent advances in the treatment of metastatic unresectable gastric cancers (MGC) include the development of new antitumor drugs and new regimens for their use. However, the selection of individually designed regimens by gastric cancer (GC) subtype remains problematic. Here, we investigated the clinical usefulness of programmed chemotherapy.
METHODOLOGY/PRINCIPAL FINDINGS: MGC patients were classified into three groups by clinical condition. We implemented a chemotherapy program consisting of S-1 combination regimens. Median survival time (MST) of level 1 patients was 416 days (95% CI: 313-506 days), with an overall response rate of 47%. MSTs of level 2 and 3 patients were 208 (95% CI: 153-287 days) and 95 days (95% CI: 28-136 days), respectively. Grade 3-4 toxicities were neutropenia in 12% and anorexia in 6%. All treatment- related toxicities were resolved, and no treatment-related deaths occurred.
CONCLUSIONS/SIGNIFICANCE: This program provided reasonable selection of case-matching regimens and may improve the survival of patients with MGC. Further, it may represent the first clinical tool to provide efficient chemotherapy course selection for MGC. Ongoing analysis of newly developed drugs and regimens will allow the efficacy of this chemotherapy program to be improved.
转移性不可切除胃癌（MGC）的治疗最近取得了进展，包括开发新的抗肿瘤药物和新的治疗方案。然而，根据胃癌（GC）亚型选择个体化设计的方案仍然存在问题。在这里，我们研究了程序化化疗的临床应用。
方法/主要发现：根据临床情况将 MGC 患者分为三组。我们实施了由 S-1 联合方案组成的化疗方案。1 级患者的中位生存时间（MST）为 416 天（95%CI：313-506 天），总缓解率为 47%。2 级和 3 级患者的 MST 分别为 208 天（95%CI：153-287 天）和 95 天（95%CI：28-136 天）。3-4 级毒性为中性粒细胞减少症 12%和食欲不振 6%。所有治疗相关毒性均得到解决，无治疗相关死亡。
结论/意义：该方案提供了合理的病例匹配方案选择，可能改善 MGC 患者的生存。此外，它可能代表第一个为 MGC 提供高效化疗方案选择的临床工具。对新开发药物和方案的持续分析将提高该化疗方案的疗效。
