Combination chemotherapy with paclitaxel, cisplatin and fluorouracil for patients with advanced and metastatic gastric or esophagogastric junction adenocarcinoma: a multicenter prospective study

摘要

Objective:To evaluate the efficacy and toxicity of the combination regimen of paclitaxel,cisplatin and 5-FU (PCF) as first-line or second-line therapy in patients with advanced gastric and esophagogastric junction (EGJ) adenocarcinoma in China.Methods:The patients were treated with paclitaxel 150 mg/m2 on d1; fractionated cisplatin 15 mg/m2 and continuous infusion 5-FU 600 mg/(m2·d) intravenously on d1-d5 of a 21-d cycle until disease progression or unacceptable toxicities.Results:Seventy-five patients have been enrolled,among which,41 received PCF regimen as the first-line therapy (group A) and 34 received the regimen as the second-line therapy (group B) with the median age of 59 years old and Karnofsky performance status (KPS) score ≥80.Toxicities were analyzed in all 75 patients.Seventy-one patients were evaluable for efficacy.The median overall survival (mOS) was 12.0 months (95％ CI:7.9-16.2 months) in group A and 7.3 months (95％ CI:4.3-10.3 months) in group B,respectively.The median progression-free survival (mPFS) was 5.7 months (95％ CI:4.1-7.2 months) and 5.0 months (95％ CI:3.1-6.9 months),respectively.The response rate (CR+PR) was 40％ (16/40; 95％ CI:24.9-56.7％) in group A and 22.6％ (7/31; 95％ CI:9.6-41.1％) in group B.Major grade 3 or 4 adverse events include neutropenia (41.3％),febrile neutropenia (9.3％),nausea/anorexia (10.7％),and vomiting (5.3％).There was no treatment-related death.Conclusions:The combination chemotherapy with PCF is active and tolerable as first-line and second-line therapy in Chinese patients with advanced gastric and EGJ adenocarcinoma.The response and survival of PCF are same as those of DCF,but the tolerance is much better.