HER2阴性转移性胃癌一线治疗后两种化疗方案的比较
Comparison of Two Chemotherapy Regimens After First-Line Treatment for HER2-Negative Metastatic Gastric Cancer.
作者信息
Urakçı Zuhat, Ebinç Senar, Tunç Sezai, Kalkan Ziya, Oruç Zeynep, Küçüköner Mehmet, Kaplan Muhammet Ali, Isikdogan Abdurrahman
机构信息
Department of Medical Oncology, Dicle University Faculty of Medicine, Diyarbakır, TUR.
Department of Medical Oncology, Gazi Yasargil Training and Research Hospital, Diyarbakır, TUR.
出版信息
Cureus. 2023 May 10;15(5):e38837. doi: 10.7759/cureus.38837. eCollection 2023 May.
AIM
Metastatic stage gastric cancer is a disease with a poor prognosis and the likelihood of achieving a cure in these patients is low. Treatment response to subsequent-line treatments is poor. We aimed to investigate the effectiveness of the folinic acid, fluorouracil and irinotecan (FOLFIRI) and paclitaxel+carboplatin regimens, which are used in subsequent lines of therapy in advanced-stage gastric cancer.
MATERIALS AND METHODS
This study included 40 patients who have metastatic stage gastric cancer and received FOLFIRI or paclitaxel+carboplatin therapy in subsequent lines of therapy between 2017 and 2022. The data of the patients were analyzed retrospectively.
RESULTS
At diagnosis median age was 51 (23-88) years. The tumor was localized in the gastroesophageal junction in eight (20%) patients and in other gastric locations in 32 (80%) patients. At diagnosis, 75% (n=30) of the patients presented with the disease in the metastatic stage, while 25% (n=10) presented with stage II-III disease. Regarding the treatments received in the second and further lines of therapy, 18 (45%) patients received paclitaxel+carboplatin and 22 (55%) patients received a FOLFIRI regimen. Of these treatments, 67.5% (n=27) were given as the second line and 32.5% (n=13) were given as third-line therapy. The objective response rate (ORR) was 45.5% in the FOLFIRI arm compared to 16.7% in the paclitaxel+carboplatin arm (p=0.05). Both treatment arms had a median progression-free survival (PFS) of three months (p=0.82). The median overall survival (OS) time was seven months in the FOLFIRI arm compared to eight months in the paclitaxel+carboplatin arm (p=0.71). Side effects were similar between both treatment arms.
CONCLUSION
This study determined that FOLFIRI and paclitaxel+carboplatin treatments have similar OS, PFS, and side effect profiles in subsequent line treatment of gastric cancer. The FOLFIRI treatment regimen yielded a higher ORR.
目的
转移性胃癌是一种预后较差的疾病，这些患者实现治愈的可能性较低。对后续治疗的反应较差。我们旨在研究亚叶酸钙、氟尿嘧啶和伊立替康（FOLFIRI）以及紫杉醇+卡铂方案在晚期胃癌后续治疗中的有效性。
材料与方法
本研究纳入了40例转移性胃癌患者，他们在2017年至2022年期间接受了FOLFIRI或紫杉醇+卡铂治疗作为后续治疗。对患者的数据进行回顾性分析。
结果
诊断时的中位年龄为51（23 - 88）岁。肿瘤位于胃食管交界处的患者有8例（20%），位于其他胃部位置的患者有32例（80%）。诊断时，75%（n = 30）的患者处于疾病转移阶段，而25%（n = 10）的患者处于II - III期疾病。关于在二线及后续治疗中接受的治疗，18例（45%）患者接受了紫杉醇+卡铂治疗，22例（55%）患者接受了FOLFIRI方案治疗。在这些治疗中，67.5%（n = 27）作为二线治疗给予，32.5%（n = 13）作为三线治疗给予。FOLFIRI组的客观缓解率（ORR）为45.5%，而紫杉醇+卡铂组为16.7%（p = 0.05）。两个治疗组的中位无进展生存期（PFS）均为三个月（p = 0.82）。FOLFIRI组的中位总生存期（OS）时间为七个月，而紫杉醇+卡铂组为八个月（p = 0.71）。两个治疗组的副作用相似。
结论
本研究确定FOLFIRI和紫杉醇+卡铂治疗在胃癌后续治疗中的总生存期、无进展生存期和副作用方面相似。FOLFIRI治疗方案产生了更高的客观缓解率。
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