Docetaxel, cisplatin and S-1 (DCS) combination chemotherapy for gastric cancer patients with peritoneal metastasis: a retrospective study
Docetaxel, cisplatin and S-1 (DCS) combination chemotherapy for gastric cancer patients with peritoneal metastasis: a retrospective study
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DOI：
10.1007/s00280-018-3523-x
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发表时间：
2018-03-01
影响因子：
3
通讯作者：
Kato, Junji
中科院分区：
文献类型：
--
作者：
Ohnuma, Hiroyuki;Sato, Yasushi;Kato, Junji
晚期或复发性胃癌（AGC）的腹膜转移（PM）是最常见的死亡原因。然而，目前的治疗方法仍不令人满意。我们之前进行了多西他赛、顺铂和S-1（DCS）联合化疗治疗AGC的研究。本研究的目的是调查DCS在PM患者中的益处和耐受性。患者被分为三组：无PM的患者（非PM）;无腹水或轻度至中度腹水的PM患者（无-Mod）;以及有大量腹水的PM患者（大量）。患者接受口服S-1（40 mg/m（2）b.i.d.）第1-14天，静脉注射顺铂（60 mg/m2）和多西他赛（50-60 mg/m2），第8天，每3周一次。111例接受DCS一线治疗的AGC患者中，37例合并PM，其中15例出现大量腹水。PM患者的有效率为81.5%。各组之间的药物暴露和毒性无显著差异。MST也相似：非PM为22.6个月，None-Mod PM为21.7个月，Massive为16.8个月。10例（27.0%）PM患者实现了降级并接受了根治性手术，随后表现出28.0个月的极好MST。多变量分析显示，OS的独立预后因素。DCS对于AGC伴PM是可行和有效的，特别是当患者PS良好时。
Peritoneal metastasis (PM) in advanced or recurrent gastric cancer (AGC) is the most frequent cause of death from this disease. However, current treatments remain unsatisfactory. We previously conducted studies of docetaxel, cisplatin and S-1 (DCS) combination chemotherapy for AGC. The aim of this study was to investigate the benefits and tolerability of DCS in PM patients.Patients were divided into three groups: patients without PM (non-PM); PM patients without ascites, or mild to moderate ascites (None-Mod); and PM patients with massive ascites (Massive). Patients received oral S-1 (40 mg/m(2) b.i.d.) on days 1-14, and intravenous cisplatin (60 mg/m(2)) and docetaxel (50-60 mg/m(2)) on day 8 every 3 weeks. Drug exposure, adverse events, tumor response, progression-free and overall survival (OS) rates were evaluated.Of the 111 AGC patients who received DCS as first-line therapy, 37 cases had complicated PM, 15 of whom displayed massive ascites. The response rate for PM patients was 81.5%. Drug exposure and toxicities were not meaningfully different among the groups. The MSTs were also similar: 22.6 months for the non-PM, 21.7 months for the None-Mod PM, and 16.8 months for the Massive, respectively. Ten (27.0%) patients with PM achieved downstaging and underwent curative surgery, subsequently demonstrating an excellent MST of 28.0 months. An independent prognostic factor for OS, as revealed by multivariate analyses. was a good performance status.DCS is feasible and efficacious for AGC with PM, especially when patients present with a good PS.