Oxaliplatin in combination with 5-fluorouracil (5-FU) and leucovorin (LV) in patients with metastatic gastric cancer (MGC)
Oxaliplatin in combination with 5-fluorouracil (5-FU) and leucovorin (LV) in patients with metastatic gastric cancer (MGC)
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DOI：
10.1097/01.coc.0000221358.57089.f2
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发表时间：
2006-08-01
影响因子：
2.6
通讯作者：
Zaniboni, Alberto
中科院分区：
文献类型：
--
作者：
Cavanna, Luigi;Artioli, Fabrizio;Zaniboni, Alberto
目的：进展期或转移性胃癌(A/MGC)的治疗选择有限，需要包含新的物质。很少有研究证实亚叶酸钙(LV)调节的奥沙利铂(OXA)和5-氟尿嘧啶(5-FU)联合治疗A/MGC的活性和耐受性。本研究的目的是评价Folfox-4方案治疗急性髓系白血病的疗效和毒副反应。治疗继续进行，直到疾病进展、不可接受的毒性或直到患者选择停止治疗。根据WHO标准和NCI毒性标准记录治疗反应和毒性反应。结果：所有患者的毒性和反应均可评估。患者(男性71.4%，女性28.6%)的平均年龄为65岁(范围为28-78岁)。所有患者均经组织学证实为转移性(89.3%)或进展期(10.7%)胃癌。每6周评估一次疗效，I组完全缓解(1.8%)，部分缓解23例(41.1%)，总有效率为42.9%。病情稳定20例(35.7%)，进展12例(21.4%)。中位生存期为10个月，进展时间为6个月，随访期为11.5个月。WHO 3级或4级血液学毒性包括白细胞减少、中性粒细胞减少、血小板减少和贫血。无一例患者出现中性粒细胞减少症。其他3/4级毒性包括恶心、呕吐、腹泻、口腔炎和厌食症。3例(5.3%)患者出现3级周围神经病变。结论：FOLFOX-4方案对进展期/转移性胃癌患者有效且耐受性良好。
Objective: Treatment options for advanced or metastatic gastric cancer (A/MGC) are limited and inclusion of novel substances is necessary. Few studies have confirmed the activity and tolerability of the combination of oxaliplatin (OXA) and 5-fluorouracil (5-FU) modulated with leucovorin (LV) administrated to patients with A/MGC. The goal of current study was to evaluate the efficacy and toxicity of Folfox-4 regimen in patients with A/MGC.Patients and Methods: Fifty-six patients were treated with Folfox-4 regimen. Treatment was continued until disease progression, unacceptable toxicity or until a patient chose to discontinue treatment. Responses to treatment and toxicity were recorded according to the WHO criteria and NCI toxicity criteria.Results: All patients were assessable for toxicity and response. Patients (71.4% male, 28.6% female) had a median age of 65 years (range, 28-78). All patients had histologically confirmed metastatic (89.3%) or advanced (10.7%) gastric cancer. Response was evaluated every 6 weeks; I complete (1.8%) and 23 (41.1%) partial remission were observed (overall response rate 42.9%). Twenty patients (35.7%) showed stable disease and 12 (21.4%) had a progressive disease. Median overall survival, time to progression and follow up were 10 months, 6 months, and 11.5 months, respectively. WHO grade 3 or 4 hematologic toxicities included leucopenia, neutropenia, thrombocytopenia, and anemia. No patient experienced neutropenic fever. Other grade 3/4 toxicities included nausea, vomiting, diarrhea, stomatitis, and anorexia. Three patients (5.3%) experienced grade 3 peripheral neuropathy. No treatment-related deaths were recorded.Conclusions: Folfox-4 regimen is active and well tolerated in patients with advanced/metastatic gastric cancer.