Maeda Osamu, Matsuoka Ayumu, Miyahara Ryoji, Funasaka Kohei, Hirooka Yoshiki, Fukaya Masahide, Nagino Masato, Kodera Yasuhiro, Goto Hidemi, Ando Yuichi
Osamu Maeda, Ayumu Matsuoka, Yuichi Ando, Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya 466-8560, Japan.
World J Gastroenterol. 2017 Feb 14;23(6):1090-1097. doi: 10.3748/wjg.v23.i6.1090.
To evaluate the feasibility of chemotherapy including fluoropyrimidine, platinum and taxane with modified dosages for unresectable gastric cancer in Japanese patients.
We performed a feasibility study of a modified docetaxel, cisplatin and capecitabine (DCX) regimen for stage IV gastric cancer. In particular, 30 or 40 mg/m of docetaxel on day 1, 60 mg/m of cisplatin on day 1, and 2000 mg/m of capecitabine for 2 wk were administered every three weeks.
Three patients were treated with modified DCX (mDCX) with 30 mg/m docetaxel, and five patients were treated with this regimen with 40 mg/m docetaxel. Grade 3 or 4 neutropenia was observed in six of the eight patients; no patients exhibited febrile neutropenia. Partial response was achieved in four of the eight patients. Three patients underwent gastrectomy, which achieved R0 resection without residual tumors in dissected lymph nodes. In one of these three patients, resected specimens revealed pathological complete response in the primary lesion and in lymph nodes.
mDCX was well tolerated by Japanese patients with stage IV gastric cancer. This regimen might be useful for allowing gastric cancer patients with distant lymph node metastasis to undergo conversion surgery.
评估含氟嘧啶、铂类和紫杉烷且剂量调整的化疗方案对日本不可切除胃癌患者的可行性。
我们对改良的多西他赛、顺铂和卡培他滨(DCX)方案用于IV期胃癌进行了可行性研究。具体而言,每三周给药一次,第1天给予多西他赛30或40mg/m²,第1天给予顺铂60mg/m²,卡培他滨2000mg/m²,持续2周。
3例患者接受了多西他赛30mg/m²的改良DCX(mDCX)方案治疗,5例患者接受了多西他赛40mg/m²的该方案治疗。8例患者中有6例出现3级或4级中性粒细胞减少;无患者出现发热性中性粒细胞减少。8例患者中有4例获得部分缓解。3例患者接受了胃切除术,实现了R0切除,清扫淋巴结无残留肿瘤。在这3例患者中的1例,切除标本显示原发灶和淋巴结病理完全缓解。
IV期胃癌日本患者对mDCX耐受性良好。该方案可能有助于远处淋巴结转移的胃癌患者接受转化手术。