Coelho Rafael C, Abreu Pedro D P, Monteiro Mariana R, Stramosk Ana Paula, Garces Alvaro Henrique I, Melo Andreia Cristina, Graudenz Marcia S, Andrade Carlos Jose C
Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil.
Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
J Glob Oncol. 2019 Jan;5:1-8. doi: 10.1200/JGO.18.00176.
Gastric cancer (GC) is the fourth most common cancer and the second leading cause of cancer death worldwide. Platinum agents and fluoropyrimidines are the main compounds used in the first-line setting for advanced GC. Given the activity of fluorouracil (FU) bolus, the PFL protocol, a chemotherapy regimen combining cisplatin, FU bolus, and leucovorin, was incorporated at the Brazilian National Cancer Institute, because this schedule does not require hospitalization or infusion pumps. This study aims to evaluate the outcomes of PFL in the first-line setting for patients with advanced GC.
This was a retrospective cohort study evaluating patients with advanced GC treated in the first-line setting with cisplatin 80 mg/m on day 1 and FU bolus 400 mg/m plus leucovorin 20 mg/m on days 1, 8, 15, and 22 every 4 weeks, from January 2008 to December 2014.
A total of 109 patients were enrolled. The median number of cycles received per patient was four (one to 11). Complete responses were achieved in 6.4% and partial responses in 14.7%. Median progression-free survival was 6.3 months (95% CI, 5.08 to 7.58 months) and median overall survival was 8.3 months (95% CI, 6.79 to 9.87 months). Thirty-four (31.2%) patients were alive in 1 year. Grade 3 and 4 adverse events were experienced by 26.6% and 3.7% of patients, respectively, with dose reduction necessary in 9.1%.
PFL is active in advanced GC and could be an alternative for FU continuous infusion protocols in institutions with limited resources and/or low budget, which is the reality in many nations all over the world.
胃癌（GC）是全球第四大常见癌症，也是癌症死亡的第二大主要原因。铂类药物和氟嘧啶是晚期GC一线治疗中使用的主要化合物。鉴于氟尿嘧啶（FU）推注的活性，巴西国家癌症研究所采用了PFL方案，即一种将顺铂、FU推注和亚叶酸联合使用的化疗方案，因为该方案无需住院或使用输液泵。本研究旨在评估PFL方案用于晚期GC患者一线治疗的疗效。
这是一项回顾性队列研究，评估2008年1月至2014年12月期间接受一线治疗的晚期GC患者，治疗方案为第1天给予顺铂80mg/m²，每4周的第1、8、15和22天给予FU推注400mg/m²加亚叶酸20mg/m²。
共纳入109例患者。每位患者接受的中位周期数为4个（1至11个）。完全缓解率为6.4%，部分缓解率为14.7%。中位无进展生存期为6.3个月（95%CI，5.08至7.58个月），中位总生存期为8.3个月（95%CI，6.79至9.87个月）。34例（31.2%）患者在1年后仍存活。分别有26.6%和3.7%的患者发生3级和4级不良事件，9.1%的患者需要降低剂量。
PFL方案对晚期GC有效，对于资源有限和/或预算较低的机构（这是世界上许多国家的实际情况），它可能是FU持续输注方案的一种替代方案。
