Department of Medical Oncology, Cerrahpasa University Faculty of Medicine, Istanbul, Turkey.
Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey.
Medicine (Baltimore). 2024 Mar 1;103(9):e37259. doi: 10.1097/MD.0000000000037259.
The prognosis of metastatic gastric cancer (GC) is poor, with a median survival time of less than a year. Capecitabine is a prodrug, metabolized by thymidine phosphorylase to its cytotoxic metabolite (5-FU). Few studies have compared capecitabine and 5-FU in mGC. In this retrospective study, we compared the efficacy and safety of modified DCF (mDCF) (docetaxel, cisplatin, and 5-FU) and modified DCX (mDCX) (docetaxel, cisplatin, and capecitabine) regimens for first-line treatment in patients with mGC. The study included 112 mGC patients treated with either mDCF (n = 69) or mDCX (n = 43) between 2010 and 2021. Demographic data, response rate, progression-free survival (PFS), overall survival (OS), and adverse events were evaluated. The complete response rate in the mDCF group was 10.1%, whereas the complete response rate in the mDCX group was 2.3%. The partial response rate for mDCF and mDCX were 29% and 37%, respectively. The 2 treatment arms of the study had the same objective rate of response and disease control rate (DCR). PFS and OS rates were comparable between the 2 groups. The median PFS in the mDCF and mDCX arms were 6.0 months (95% CI, 4.87-7.14) and 5.0 months (95% CI, 4.10-5.90) respectively (P = .08). The median OS in the mDCF and mDCX arms were 9.0 months (95% CI, 7.53-10.47) and 9.0 months (95% CI, 6.87-11.11) respectively (P = .07). Neutropenia, asthenia, stomatitis, and nausea/vomiting were the most frequently reported grade 3 to 4 adverse events (AEs). The rates of grade 3/4 AEs and dose reduction were comparable between the 2 groups. There was no treatment discontinuation due to grade 3 to 4 AE. As a first-line treatment for patients with mGC, mDCX and mDCF regimens have comparable efficacy and tolerability profiles.
转移性胃癌（GC）的预后较差，中位生存时间不到一年。卡培他滨是一种前体药物，可被胸苷磷酸化酶代谢为其细胞毒性代谢物（5-FU）。很少有研究比较过卡培他滨和 5-FU 在 mGC 中的应用。在这项回顾性研究中，我们比较了改良 DCF（mDCF）（多西他赛、顺铂和 5-FU）和改良 DCX（mDCX）（多西他赛、顺铂和卡培他滨）方案在一线治疗 mGC 患者中的疗效和安全性。该研究纳入了 2010 年至 2021 年期间接受 mDCF（n=69）或 mDCX（n=43）治疗的 112 例 mGC 患者。评估了人口统计学数据、缓解率、无进展生存期（PFS）、总生存期（OS）和不良事件。mDCF 组完全缓解率为 10.1%，而 mDCX 组完全缓解率为 2.3%。mDCF 和 mDCX 的部分缓解率分别为 29%和 37%。研究的 2 个治疗组的客观缓解率和疾病控制率（DCR）相同。2 组的 PFS 和 OS 率相当。mDCF 和 mDCX 组的中位 PFS 分别为 6.0 个月（95%CI，4.87-7.14）和 5.0 个月（95%CI，4.10-5.90）（P=0.08）。mDCF 和 mDCX 组的中位 OS 分别为 9.0 个月（95%CI，7.53-10.47）和 9.0 个月（95%CI，6.87-11.11）（P=0.07）。中性粒细胞减少、乏力、口腔炎和恶心/呕吐是最常见的 3 级或 4 级不良事件（AE）。2 组 3/4 级 AE 的发生率和剂量减少率相当。没有因 3 级或 4 级 AE 而停止治疗的情况。作为 mGC 患者的一线治疗，mDCX 和 mDCF 方案具有相当的疗效和耐受性。
