Oxaliplatin, 5-fluorouracil and Leucovorin (FOLFOX-4) Combination Chemotherapy as a Salvage Treatment in Advanced Gastric Cancer
Oxaliplatin, 5-fluorouracil and Leucovorin (FOLFOX-4) Combination Chemotherapy as a Salvage Treatment in Advanced Gastric Cancer
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DOI：
10.4143/crt.2010.42.1.24
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发表时间：
2010-03-01
影响因子：
4.6
通讯作者：
Shin, Dong Bok
中科院分区：
文献类型：
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作者：
Kim, Young Saing;Hong, Junshik;Shin, Dong Bok
目的本研究旨在确定 FOLFOX-4 化疗作为晚期胃癌 (AGC) 患者挽救治疗的有效性和安全性。 材料和方法 ECOG 表现状态为 0 至 1 相似且先前治疗后疾病进展的 AGC 患者被登记到本 II 期试验中。患者每两周接受奥沙利铂（第 1 天 85 mg/m(2)）、亚叶酸（第 1 和第 2 天 200 mg/m(2)）和 5-氟尿嘧啶（400 mg/m(2) 推注，第 1 和第 2 天 22 小时输注 600 mg/m(2)）。结果 对于 42 名接受治疗的患者，总共进行了 228 个化疗周期（中位数：5，范围：1 至 12）。 29 名患者 (69%) 接受 FOLFOX-4 化疗作为第三线 (50%) 或第四线 (19%) 治疗。在意向治疗分析中，9 名患者 (21%) 取得了部分缓解，并维持了 4.6 个月。中位无进展生存期和总生存期分别为 3.0 个月和 6.2 个月。经常遇到的毒性是中性粒细胞减少症和胃肠道副作用，包括厌食症。虽然可能存在一种与治疗相关的死亡，但毒性特征通常是可预测和可控的。 结论 对于那些已接受过大量治疗、体力状态良好的 AGC 患者来说，FOLFOX-4 挽救性化疗是一种有效且可耐受的方案。
PurposeThis study was designed to determine the efficacy and safety of FOLFOX-4 chemotherapy as a salvage treatment for patients with advanced gastric cancer (AGC).Materials and MethodsThe AGC patients with an ECOG performance status of 0 similar to 1 and progressive disease after prior treatments were registered onto this phase II trial. The patients received oxaliplatin (85 mg/m(2) on day 1), leucovorin (200 mg/m(2) on days 1 and 2) and 5-fluorouracil (400 mg/m(2) as a bolus and 600 mg/m(2) as a 22-hour infusion on days 1 and 2) every 2 weeks.ResultsFor the 42 treated patients, a total of 228 chemotherapy cycles (median: 5, range: 1 similar to 12) were administered. Twenty-nine patients (69%) received FOLFOX-4 chemotherapy as a third(50%) or fourth-line (19%) treatment. On the intent-to-treat analysis, 9 patients (21%) achieved a partial response, which was maintained for 4.6 months. The median progression-free survival and overall survival were 3.0 months and 6.2 months, respectively. The frequently encountered toxicities were neutropenia and gastrointestinal side effects, including anorexia. Although there was one possible treatment-related death, the toxicity profiles were generally predictable and manageable.ConclusionSalvage chemotherapy with FOLFOX-4 is an effective and tolerable regimen for those heavily pretreated AGC patients who have a good performance status.