Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
PLoS One. 2018 Oct 22;13(10):e0205853. doi: 10.1371/journal.pone.0205853. eCollection 2018.
The survival benefit of second-line chemotherapy in patients with metastatic gastric cancer (MGC) has recently been established. We conducted a nationwide population-based outcomes study of patients with MGC receiving second-line chemotherapy to better understand real-world treatment patterns and outcomes.
Data were collected from the Health Insurance Review and Assessment Service database. We identified 509 newly diagnosed patients with MGC in 2010 who received second-line chemotherapy. These patients were divided into three groups for analyses: Group A comprised all patients who received second-line chemotherapy (N = 509); Group B comprised those who received fluoropyrimidine (Fp) plus platinum as first-line treatment, followed by irinotecan-based or taxane-based regimens as second-line chemotherapy (N = 284); and Group C comprised those who received Fp plus cisplatin as first-line treatment, followed by 5-fluorouracil (5-FU)/oxaliplatin, irinotecan-based, or taxane-based regimens as second-line chemotherapy (N = 184).
Among patients who received first-line chemotherapy, 47.2% (509/1,078) continued to receive second-line chemotherapy. The most commonly used second-line chemotherapy regimens were 5-FU/irinotecan, 5-FU/oxaliplatin, and docetaxel. The median overall survival (OS) of all 509 patients was 5.2 months. The time from the start date of first-line chemotherapy to the start date of second-line chemotherapy > 6.1 months was an independent prognostic factor for improved OS. The type of chemotherapy regimen was not a significant factor affecting OS.
The findings provide a better understanding of second-line treatment patterns and outcomes in patients with MGC and will help guide treatment decisions in real-world clinical practice.
二线化疗在转移性胃癌（MGC）患者中的生存获益最近已经得到证实。我们进行了一项全国性基于人群的 MGC 患者二线化疗结局研究，以更好地了解真实世界的治疗模式和结局。
数据来自健康保险审查和评估服务数据库。我们在 2010 年识别了 509 例新诊断的 MGC 患者，他们接受了二线化疗。这些患者被分为三组进行分析：A 组包括接受二线化疗的所有患者（N=509）；B 组包括接受氟嘧啶（Fp）加铂类药物作为一线治疗，随后接受伊立替康或紫杉醇类药物作为二线化疗的患者（N=284）；C 组包括接受 Fp 加顺铂作为一线治疗，随后接受 5-氟尿嘧啶（5-FU）/奥沙利铂、伊立替康或紫杉醇类药物作为二线化疗的患者（N=184）。
在接受一线化疗的患者中，47.2%（509/1,078）继续接受二线化疗。最常用的二线化疗方案是 5-FU/伊立替康、5-FU/奥沙利铂和多西他赛。所有 509 例患者的中位总生存期（OS）为 5.2 个月。从一线化疗开始日期到二线化疗开始日期>6.1 个月是 OS 改善的独立预后因素。化疗方案类型不是影响 OS 的显著因素。
这些发现提供了对 MGC 患者二线治疗模式和结局的更好理解，并将有助于指导真实世界临床实践中的治疗决策。
