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A Comparison of Weekly DCF versus Standard DCF as First-line Systemic Chemotherapy for Metastatic Gastric Cancer Patients

DOI: 
10.7727/wimj.2016.536

ABSTRACT

Objective: In metastatic gastric cancer (MGC), the goals of treatment are palliation and prolongation of overall survival (OS). Systemic chemotherapy, with docetaxel, cisplatin, infusional 5-fluorouracil(DCF) the most preferred regimen, is the mainstay of the treatment. We evaluated the efficacy and tolerability of weekly DCF (wDCF) compared to standard DCF regimen.

Methods: We retrospectively reviewed 49 and 32 MGC patients treated with DCF and wDCF regimens as first-line treatment, respectively. The wDCF protocol included 25 mg/m² docetaxel, 25 mg/m² cisplatin and 750 mg/m² infusional 5-FU on day 1, every week. Each cycle was repeated every 3 weeks.

Results: The patients in wDCF arm were significantly older (median 54 vs 72.5) and had poor Eastern Cooperative Oncology Group performance status (ECOG PS) than patients in DCF arm (p<0.001). PFS was 3 vs 5 months (p>0.05) and OS was 7 vs 9 months in DCF and wDCF arms (p>0.05), respectively. Overall response rate (ORR) was observed in 28.5% and 31.2% of the patients in DCF and wDCF arms, respectively (p=0.65). Hematologic toxicities were observed more common in wDCF arm.

 Conclusions: wDCF is an effective and tolerable regimen and may be an alternative in patients who are elderly and have poor ECOG PS.

Accepted: 
30 May, 2017
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e-Published: 01 May, 2017

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