International Journal of Hematology and Oncology
2023, Vol 33, Num 4 Page(s): 171-177
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Reduced Doses of Docetaxel and Cisplatinum Plus 5 Fluorouracil Combination Chemotherapy in Metastatic Esophagogastric Adenocarcinoma: The Impact on Outcomes
Tulay EREN1, Nuriye OZDEMIR2, Ozan YAZICI3, Goksen I. IMAMOGLU1, Dogan YAZILITAS1, Süheyla A. ARSLAN4, Nurullah ZENGIN2
1Diskapi Yıldırım Beyazıt Research and Training Hospital, Department of Oncology, Ankara, TURKEY
2Yıldırım Beyazıt University, Faculty of Medicine, Department of Oncology, Ankara, TURKEY
3Numune Research and Training Hospital, Department of Oncology, Ankara, TURKEY
4Yıldırım Beyazıt University, Faculty of Medicine, Department of Radiation Oncology, Ankara, TURKEY
Keywords: Metastatic esofagogastric cancer, Modified DCF, mDCF, Efficacy, Toxicity, Progression free survival, Overall survival
Docetaxel-cisplatin-5-fluorourasil (DCF) protocol is one of the standard regimen at present however it is difficult to administer owing to high toxicity rates. The aim of study was to modify the dose of DCF regimen in order to render it more tolerable and to evaluate the efficacy and tolerability of modified DCF (mDCF) protocol. 267 patients followed in Ankara Numune Hospital were included in the study. All patients were administered mDCF regimen as metastatic first line treatment. Doses in mDCF arm was as follows: docetaxel 60 mg/ m2 1. day, cisplatin 60 mg/m2 1. day and 5-fluorouracil 600 mg/m2/day (1-5 days) every three weeks In the study, files of overall 267 patients who did not previously receive treatment were evaluated retrospectively. Median number of cycles in all patients was 6 (range 2-10). Median age of patients was 55 (range 22-76). Median follow up period was 9 months. Complete response 5 (1.9%) patients, partial response 74 (27.7%) patients and stable disease 95 (35.6%) patient. Median PFS was 6.0 (95%CI, 5.3-6.6) months, and median OS 10.0 (95% CI, 8.8-11.1) months. Parameters effect in univariate analysis were submitted to multivariate analysis results were CEA, grade, ECOG effective on OS. Grade 3-4 neutropenia was found 28.1%, anemia 11.6%, thrombocytopenia 4.1% and Febrile neutropenia 4.9%. Although mDCF regimen seems to be as effective as original DCF regimen, grade 3-4 toxicity rates were found to be lower. mDCF may be preferred as a tolerable and effective regimen in ECOG 0-2 metastatic gastric cancers.
Tulay EREN1, Nuriye OZDEMIR2, Ozan YAZICI3, Goksen I. IMAMOGLU1, Dogan YAZILITAS1, Süheyla A. ARSLAN4, Nurullah ZENGIN2
1Diskapi Yıldırım Beyazıt Research and Training Hospital, Department of Oncology, Ankara, TURKEY
2Yıldırım Beyazıt University, Faculty of Medicine, Department of Oncology, Ankara, TURKEY
3Numune Research and Training Hospital, Department of Oncology, Ankara, TURKEY
4Yıldırım Beyazıt University, Faculty of Medicine, Department of Radiation Oncology, Ankara, TURKEY
Keywords: Metastatic esofagogastric cancer, Modified DCF, mDCF, Efficacy, Toxicity, Progression free survival, Overall survival
Docetaxel-cisplatin-5-fluorourasil (DCF) protocol is one of the standard regimen at present however it is difficult to administer owing to high toxicity rates. The aim of study was to modify the dose of DCF regimen in order to render it more tolerable and to evaluate the efficacy and tolerability of modified DCF (mDCF) protocol. 267 patients followed in Ankara Numune Hospital were included in the study. All patients were administered mDCF regimen as metastatic first line treatment. Doses in mDCF arm was as follows: docetaxel 60 mg/ m2 1. day, cisplatin 60 mg/m2 1. day and 5-fluorouracil 600 mg/m2/day (1-5 days) every three weeks In the study, files of overall 267 patients who did not previously receive treatment were evaluated retrospectively. Median number of cycles in all patients was 6 (range 2-10). Median age of patients was 55 (range 22-76). Median follow up period was 9 months. Complete response 5 (1.9%) patients, partial response 74 (27.7%) patients and stable disease 95 (35.6%) patient. Median PFS was 6.0 (95%CI, 5.3-6.6) months, and median OS 10.0 (95% CI, 8.8-11.1) months. Parameters effect in univariate analysis were submitted to multivariate analysis results were CEA, grade, ECOG effective on OS. Grade 3-4 neutropenia was found 28.1%, anemia 11.6%, thrombocytopenia 4.1% and Febrile neutropenia 4.9%. Although mDCF regimen seems to be as effective as original DCF regimen, grade 3-4 toxicity rates were found to be lower. mDCF may be preferred as a tolerable and effective regimen in ECOG 0-2 metastatic gastric cancers.
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