改良DCF方案治疗27例晚期胃癌的疗效及毒副作用观察(英文)

Objective: The aim of this study was to evaluate the efficacy and toxicity of modified docetaxel, cisplatin and calcium folinate (CF)/5-fluorouracil (mDCF) combination therapy for 27 patients with recurrent or metastatic gastric adeno- carcinoma (R/MGC). Methods: From May 2006 to July 2007, 27 R/MGC patients (18 were male and 9 were female) with a median age of 49 years (range19-66) were consecutively enrolled. The mDCF protocol included 50 mg/m2 docetaxel for 1 day and 25 mg/m2 cisplatin on d2-3, 200 mg/m2 CF on d2-3 and 2000 mg/m2 5-fluorouracil (5-FU) CIV (continous infusion) for 46 h on d2-3, repeated every 2 weeks. Results: Twenty-seven patients were evaluable for efficacy and toxicity. A median of 4.5 cycles was given. One complete and 12 partial responses were observed for an overall intent to treat response rate (RR) 48.1% [95% CI (confidence intervals): 32%-64%]. Median time-to-progression (TTP) was 6.2 months and overall survival (OS) was 11.8 months. Twenty-seven (100%) patients experienced bone marrow suppression, and of them 48.9% were Grade 3-4 (16.3% were Grade 4). Two patients (7.4%) ceased chemotherapy because of bone marrow suppression. WHO Grade 1-4 non-hematological toxicity, such as oral mucositis, nausea/emesia, peripheral neuropathy, liver dysfunction, diarrhea, nephrotoxicity and cardiotoxicity, occurred in 59.2%、51.9%, 48.1%, 44.4%, 25.9%, 18.5% and 11.1% patients, respectively, and most of them were Grade 1-2. No patient died due to chemotherapy toxicity. Conclusion: mDCF regimen is effective in treating R/MGC with a high RR and long TTP/OS in this trial. Despite its severe hematotoxicity, this regimen has some advantages such as no cross-resistance with paclitaxel (paclitaxel-resistant patients RR 2/6). These results suggested that the mDCF regimen worth further investigation in clinical study of R/MGC treatment.