Comparative Study of the Clinical Effect between Docetaxel-based Three and Two Drugs Adjuvant Chemotherapy for Patients after Radical Gastrectomy_West China Medical Journal

Authors：

MAO Zhiyuan , GUO Xiaochuan , SU Dan , ZHANG Tingting ,  BAI Li.

Department of Oncology, the General Hospital of PLA, Beijing 100853, P. R. China;

Corresponding?author：

BAI Li., Email: maozhiyuan666@163.com

Keywords：

胃癌; 多西他賽; 輔助化學療法; 療效分析

DOI：

10.7507/1002-0179.20130492

Video：

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目的　觀察多西他賽三藥及兩藥聯合對胃癌根治術后輔助化學療法（化療）的療效比較及不良反應。方法　回顧性分析解放軍總醫院2006年1月－2011年12月42 例胃癌根治術后患者的臨床資料，其中有22例、20例患者分別接受以多西他賽為基礎的三藥、兩藥聯合輔助化療。三藥聯合：多西他賽注射液+鉑類+氟尿嘧啶/卡培他濱片/替吉奧；兩藥聯合：多西他賽注射液+氟尿嘧啶/卡培他濱片/替加氟或多西他賽注射液+鉑類；主要觀察終點：無疾病生存期（DFS），次要觀察終點：預后因素分析、復發轉移情況、不良反應及亞組分析。結果　兩組中位DFS分別為9.530、7.170個月（P=0.646）；性別、年齡、腫瘤浸潤深度、脈管癌栓、淋巴結清掃范圍是患者早期復發轉移的不良預后因素，三藥聯合組肝轉移率高于兩藥聯合組（P=0.008）；主要不良反應為惡心、嘔吐、白細胞減少、腹瀉、脫發、血小板減少等，多為1～2級，可耐受，三藥聯合組較兩藥聯合組易出現不良反應（P=0.011），以惡心、嘔吐為主。結論　胃癌根治術后以多西他賽為基礎的輔助化療三藥、兩藥聯合對患者療效及預后無明顯差異，且兩種輔助療法不良反應基本可耐受。

Citation： MAO Zhiyuan,GUO Xiaochuan,SU Dan,ZHANG Tingting,BAI Li.. Comparative Study of the Clinical Effect between Docetaxel-based Three and Two Drugs Adjuvant Chemotherapy for Patients after Radical Gastrectomy. West China Medical Journal, 2013, 28(10): 1559-1563. doi: 10.7507/1002-0179.20130492 Copy

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3.	Jemal A, Bray F, Center MM, et al. Global cancer statistics[J]. CA Cancer J Clin, 2011, 61(2): 69-90.
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6.	Kim JH, Park SS, Park SH, et al. Clinical significance of immunohistochemically-identified lymphatic and/or blood vessel tumor invasion in gastric cancer[J]. J Surg Res, 2010, 162(2): 177-183.
7.	吳亮亮, 梁寒, 王曉娜, 等. 胃癌根治術后早期復發轉移的相關因素分析[J]. 中華外科雜志, 2010, 48(20): 1542-1545.
8.	Japanese Gatric Cancer Association. Japanese classification of gastric carcinoma. 2nd English Edition[J]. Gastric Cancer, 1998, 1(1): 10-24.
9.	Ito S, Nakanishi H, Kodera Y, et al. Prospective validation of quantitative CEA mRNA detection in peritoneal washes in gastric carcinoma patients[J]. Br J Cancer, 2005, 93(9): 986-992.
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11.	Huang KH, Chen JH, Wu CW, et al. Factors affecting recurrence in node-negative advanced gastric cancer[J]. J Gastroenterol Hepatol, 2009, 24(9): 1522-1526.
12.	Panzini I, Gianni L, Fattori PP, et al. Adjuvant chemotherapy in gastric cancer: a meta-analysis of randomized trials and a comparison with previous meta-analyses[J]. Tumori, 2002, 88(1): 21-27.
13.	Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010[J]. CA Cancer J Clin, 2010, 60(5): 277-300.
14.	Mezhir JJ, Pillarisetty VG, Shah MA, et al. Randomized clinical trials in gastric cancer[J]. Surg Oncol Clin N Am, 2010, 19(1): 81-100.
15.	Sakuramoto S, Sasako M, Yamaguchi T, et al. Adjuvant chemotherapy for gastric Cancer with S-1, an oral fluoropyrimidine[J]. N Engl J Med, 2007, 357(18): 1810-1820.
16.	Nakata B, Tsuji A, Mitachi Y, et al. PhaseⅡ trial of S-1 plus low-dose cisplatin for unresectable and recurrent gastric cancer (JFMC27-9902 Step2)[J]. Oncology, 2010, 79(5-6): 337-342.
17.	Bang YJ, Kim YW, Yang HK, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial[J]. Lancet, 2012, 379(9813): 315-321.
18.	Mavroudis D, Kourousis C, Androulakis N, et al. Frontline treatment of advanced gastric cancer with docetaxel and granulocyte colony-stimulating factor (G-CSF): a phaseⅡ trial[J]. Am J Clin Oncol, 2000, 23(4): 341-344.
19.	Bang YJ, Kang WK, Kang YK, et al. Docetaxel 75 mg/m2 is active and well tolerated in patients with metaststic or recurrent gastic cancer: a phase Ⅱ trial[J]. Jpn J Clin Oncol, 2002, 32(7): 248-254.
20.	Moehler MH, Thuss-Patience P, Arndd D, et al. Docetaxel, oxaliplatin, and Capecitabine(TEX regimen)for patients with meta static gastric cancer:interim results from a phaseⅡ trial by the German AIO Group[J]. J Clin Oncol (Meeting Abstracts), 2009, 27(1): 45-54.
21.	Shankaran V, Mulcahy MF, Hochster HS, et al. Docetaxel, oxaliplatin, and 5-fluorouracil for the treatment of metastatic or unresectable gastric or gastroesophageal junction (GEJ)adenocarcinomas: preliminary results of a phaseⅡ study[J]. Gastrointestinal Cancers Synposium, 2009, 23(1): 47.

1. 　Catalano V, Labianca R, Beretta GD, et al. Gastric cancer[J]. Crit Rev Oncol Hematol, 2009, 71(2): 127-164.
2. 　Crew KD, Neugut A. Epidemiology of gastric cancer[J]. World J Gastroenterol, 2006, 12(3): 354-362.
3. 　Jemal A, Bray F, Center MM, et al. Global cancer statistics[J]. CA Cancer J Clin, 2011, 61(2): 69-90.
4. 　Deng J, Liang H, Wang D, et al. Investigation of the recurrence patterns of gastric cancer following a curative resection[J]. Surg Today, 2011, 41(2): 210-215.
5. 　La Torre M, Rossi Del Monte S, Ferri M, et al. Peritoneal washing cytology in gastric cancer. How, When and who will get a benifit. A review[J]. Minerva Gastroenterol Dietol, 2011, 57(1): 43-51.
6. 　Kim JH, Park SS, Park SH, et al. Clinical significance of immunohistochemically-identified lymphatic and/or blood vessel tumor invasion in gastric cancer[J]. J Surg Res, 2010, 162(2): 177-183.
7. 　吳亮亮, 梁寒, 王曉娜, 等. 胃癌根治術后早期復發轉移的相關因素分析[J]. 中華外科雜志, 2010, 48(20): 1542-1545.
8. 　Japanese Gatric Cancer Association. Japanese classification of gastric carcinoma. 2nd English Edition[J]. Gastric Cancer, 1998, 1(1): 10-24.
9. 　Ito S, Nakanishi H, Kodera Y, et al. Prospective validation of quantitative CEA mRNA detection in peritoneal washes in gastric carcinoma patients[J]. Br J Cancer, 2005, 93(9): 986-992.
10. 　Saito H, Osaki T, Murakami D, et al. Macroscopic tumor size as a simple prognostic indicator in patients with gastric cancer[J]. Am J Surg, 2006, 192(3): 296-300.
11. 　Huang KH, Chen JH, Wu CW, et al. Factors affecting recurrence in node-negative advanced gastric cancer[J]. J Gastroenterol Hepatol, 2009, 24(9): 1522-1526.
12. 　Panzini I, Gianni L, Fattori PP, et al. Adjuvant chemotherapy in gastric cancer: a meta-analysis of randomized trials and a comparison with previous meta-analyses[J]. Tumori, 2002, 88(1): 21-27.
13. 　Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010[J]. CA Cancer J Clin, 2010, 60(5): 277-300.
14. 　Mezhir JJ, Pillarisetty VG, Shah MA, et al. Randomized clinical trials in gastric cancer[J]. Surg Oncol Clin N Am, 2010, 19(1): 81-100.
15. 　Sakuramoto S, Sasako M, Yamaguchi T, et al. Adjuvant chemotherapy for gastric Cancer with S-1, an oral fluoropyrimidine[J]. N Engl J Med, 2007, 357(18): 1810-1820.
16. 　Nakata B, Tsuji A, Mitachi Y, et al. PhaseⅡ trial of S-1 plus low-dose cisplatin for unresectable and recurrent gastric cancer (JFMC27-9902 Step2)[J]. Oncology, 2010, 79(5-6): 337-342.
17. 　Bang YJ, Kim YW, Yang HK, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial[J]. Lancet, 2012, 379(9813): 315-321.
18. 　Mavroudis D, Kourousis C, Androulakis N, et al. Frontline treatment of advanced gastric cancer with docetaxel and granulocyte colony-stimulating factor (G-CSF): a phaseⅡ trial[J]. Am J Clin Oncol, 2000, 23(4): 341-344.
19. 　Bang YJ, Kang WK, Kang YK, et al. Docetaxel 75 mg/m2 is active and well tolerated in patients with metaststic or recurrent gastic cancer: a phase Ⅱ trial[J]. Jpn J Clin Oncol, 2002, 32(7): 248-254.
20. 　Moehler MH, Thuss-Patience P, Arndd D, et al. Docetaxel, oxaliplatin, and Capecitabine(TEX regimen)for patients with meta static gastric cancer:interim results from a phaseⅡ trial by the German AIO Group[J]. J Clin Oncol (Meeting Abstracts), 2009, 27(1): 45-54.
21. 　Shankaran V, Mulcahy MF, Hochster HS, et al. Docetaxel, oxaliplatin, and 5-fluorouracil for the treatment of metastatic or unresectable gastric or gastroesophageal junction (GEJ)adenocarcinomas: preliminary results of a phaseⅡ study[J]. Gastrointestinal Cancers Synposium, 2009, 23(1): 47.

West China Medical Journal

Comparative Study of the Clinical Effect between Docetaxel-based Three and Two Drugs Adjuvant Chemotherapy for Patients after Radical Gastrectomy

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