Weekly Docetaxel, Cisplatin, and 5-Fluorouracil as Initial Therapy for Patients With Advanced Gastric and Esophageal Cancer
Weekly Docetaxel, Cisplatin, and 5-Fluorouracil as Initial Therapy for Patients With Advanced Gastric and Esophageal Cancer
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DOI：
10.1002/cncr.24925
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发表时间：
2010-03-15
期刊：
影响因子：
6.2
通讯作者：
Phan, Alexandria
中科院分区：
文献类型：
--
作者：
Overman, Michael J.;Kazmi, Syed M.;Phan, Alexandria
背景：多西他赛、顺铂和5-氟尿嘧啶（DCF）每3周给药一次，治疗相关不良事件发生率较高。本研究的目的是评价DCF每周一次制剂的疗效和耐受性。方法：数据来自117例在德克萨斯大学M。D.回顾性收集了2002年至2006年安德森癌症中心使用每周一次DCF制剂的患者。共有95例患者接受一线治疗，顺铂20 mg/m2，5-氟尿嘧啶350 mg/m2，多西他赛20 mg/m2，每周给药一次，连续6周，随后停药2周。研究结果：95例患者（中位年龄62岁[范围33 - 87岁]，67%的东部肿瘤协作组体能状态评分为1或2）接受了中位10周的DCF治疗（范围3-41周）。3级或4级血液学毒性（根据美国国家癌症研究所常见毒性标准[3.0版]评估）包括粒细胞减少症（4例患者）和贫血（9例患者）。没有患者发生发热性血小板减少性感染，但8例患者发生3级或4级非血小板减少性感染。80例患者有可测量的疾病，根据实体瘤疗效评价标准（RECIST）标准确定的客观缓解率为34%（95%置信区间[95% CI]，24-45%）。中位随访时间为9个月，中位疾病进展时间为4.1个月（95% CI，3.6-5.7个月），中位总生存期为8.9个月（95% CI，7.7-10.8个月）。结论：在不适合每3周一次DCF的晚期胃癌和食管癌患者中，每周一次DCF制剂显示出适度的活性和最小的血液学毒性，表明每周一次DCF是此类患者的合理治疗选择。Cancer 2010;116：1446-53. (C)2070美国癌症协会
BACKGROUND: Docetaxel, cisplatin, and 5-flurouracil (DCF) administered every 3 weeks produces a high rate of treatment-related adverse events. The objective of the current study was to evaluate the efficacy and tolerability of a weekly formulation of DCF. METHODS: Data from 117 patients treated at The University of Texas M. D. Anderson Cancer Center from 2002 to 2006 with a weekly formulation of DCF were retrospectively collected. A total of 95 patients received front-line therapy with 20 mg/m(2) of cisplatin, 350 mg/m(2) of 5-fluorouracil, and 20 mg/m(2) of docetaxel administered once weekly for 6 consecutive weeks followed by a 2-week break. RESULTS: Ninety-five patients (median age, 62 years [range, 33 to 87 years], with an Eastern Cooperative Oncology Group performance status of 1 or 2 in 67%) received a median of 10 weeks of DCF treatment (range, 3-41 weeks). Grade 3 or 4 hematologic toxicity (assessed according to National Cancer Institute Common Toxicity Criteria [version 3.0]) included granulocytopenia (4 patients) and anemia (9 patients). None of the patients developed a febrile neutropenic infection, but grade 3 or 4 non-neutropenic infections occurred in 8 patients. Eighty patients had measurable disease with an objective response rate determined by Response Evaluation Criteria in Solid Tumors (RECIST) criteria of 34% (95% confidence interval [95% CI], 24-45%). The median follow-up was 9 months, with a median time to disease progression of 4.1 months (95% CI, 3.6-5.7 months) and a median overall survival of 8.9 months (95% CI, 7.7-10.8 months). CONCLUSIONS: In patients with advanced gastric and esophageal cancer who were not candidates for every-3-week DCF, a weekly formulation of DCF demonstrated modest activity with minimal hematologic toxicity, suggesting that weekly DCF is a reasonable treatment option for such patients. Cancer 2010;116:1446-53. (C) 2070 American Cancer Society.