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多西他赛每两周密集给药联合5-氟尿嘧啶作为晚期胃癌一线治疗的II期试验

Dose-dense biweekly docetaxel combined with 5-fluorouracil as first-line treatment in advanced gastric cancer: a phase II trial.

作者信息

Xiao Jian, Chen Yonghe, Li Wenyun, Gong Jiaying, Zhou Zhiyang, Deng Yanhong, Wang Lei, Ren Donglin, Wang Jianping, Peng Junsheng, Lan Ping

机构信息

Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, 26 Yuancun Erheng Road, Guangzhou, 510655, China.

出版信息

Med Oncol. 2015 Feb;32(2):334. doi: 10.1007/s12032-014-0334-8. Epub 2015 Jan 22.

Abstract

This study evaluated the efficacy, safety and impact on quality of life (QoL) of a dose-dense biweekly regimen of docetaxel and 5-fluorouracil in first-line treatment of advanced gastric cancer (AGC). Eligible patients received docetaxel 60 mg/m(2) and 5-fluorouracil (400 mg/m(2) bolus followed by 2,400 mg/m(2) 46-h infusion), fortnightly. Prophylactic use of G-CSF was adopted in all patients. The primary end point was response rate (RR). Secondary end points were progression-free survival (PFS), overall survival (OS), toxicity and QoL. Thirty-nine patients with a median age of 55 (28-80) were included. The RR was 51.3 %. Median PFS and OS were 6.7 and 14.0 months, respectively. The most common adverse events (all grades) were anemia (34, 87.2 %), fatigue (29, 74.4 %), neutropenia (26, 66.7 %), nail change (19, 48.7 %) and liver dysfunction (15, 38.5 %). In QoL analysis, improvements were obtained in seven scales, whereas drops were seen in three scales. Common Grade 3/4 toxicities included anemia (28.2 %), liver dysfunction (7.7 %) and fatigue (7.7 %). This novel regimen is a promising option for AGC, showing high RR, improvement on QoL and acceptable toxicity.

摘要

本研究评估了多西他赛与5-氟尿嘧啶每两周一次的剂量密集方案在晚期胃癌(AGC)一线治疗中的疗效、安全性及对生活质量(QoL)的影响。符合条件的患者每两周接受一次多西他赛60mg/m²和5-氟尿嘧啶(400mg/m²静脉推注,随后46小时持续输注2400mg/m²)治疗。所有患者均采用预防性使用粒细胞集落刺激因子(G-CSF)。主要终点为缓解率(RR)。次要终点为无进展生存期(PFS)、总生存期(OS)、毒性和生活质量。纳入了39例患者,中位年龄为55岁(28 - 80岁)。缓解率为51.3%。中位无进展生存期和总生存期分别为6.7个月和14.0个月。最常见的不良事件(所有级别)为贫血(34例,87.2%)、疲劳(29例,74.4%)、中性粒细胞减少(26例,66.7%)、指甲改变(19例,48.7%)和肝功能障碍(15例,38.5%)。在生活质量分析中,七个量表得到改善,而三个量表出现下降。常见的3/4级毒性包括贫血(28.2%)、肝功能障碍(7.7%)和疲劳(7.7%)。这种新方案是晚期胃癌的一个有前景的选择,显示出高缓解率、生活质量改善和可接受的毒性。

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