Abstract
Advanced gastric cancer (AGC) patients have a poor prognosis. The best benefit of chemotherapy is usually achieved by first line setting. Very few studies have compared combination regimens. This study was designed to compare two combination regimens. Patients with advanced gastric cancer receiving first line chemotherapy were retrospectively collected, and divided into two groups, receiving DCF (docetaxel, cisplatin and fluorouracil) or ECF (epirubicin, cisplatin and fluorouracil) regimens. Data were collected for the retrospective analysis in a single center. Eighty-six patients were eligible for analysis. Median overall survival (OS) was 10.0 months in the ECF group and 11.0 months in the DCF group (p=0.31). Median progression free survival (PFS) for ECF and DCF was equal at 6.0 months. Second line chemotherapy were administered in more than one third of patients. Both regimens had similar toxicity. This is the first study investigating the outcomes of gastric cancer chemotherapy in this region. ECF and DCF regimens have similar efficacy and a similar tolerability profile for first line treatment of advanced gastric cancer. The decision of the first line chemotherapy in advanced gastric cancer could be improved with patient selection according to clinical parameters and molecular markers.
Highlights
Gastric cancer (GC) is the second leading cause of cancer death and the fourth most common type of cancer
Recent studies showed the polymorphisms of dihydropyrimidine dehydrogenase genes and tymidylate synthase genotips are valuable predictors of the response to fluorouracil based chemotherapy for gastric cancer patients in adjuvant and metastatic setting (Zhang et al, 2012, Gao et al, 2013)
S1 plus cisplatin is accepted as standard first line computerised tomography (CT) for advanced gastric cancer in Japan whereas S1 is not popular in western countries
Summary
Gastric cancer (GC) is the second leading cause of cancer death and the fourth most common type of cancer. 989,600 new cases and 738,000 deaths per year can be encountered (Nagini, 2012). Major risk factors for stomach cancer are hypothesized to be nutritional and environmental, including Helicobacter pylori (H. pylori) infection, the prevalence of which ranges from 25% in developed countries to 80-90% in developing countries (Paunder, 2002). The geographic distribution of GC is characterized by a wide international variation; high-risk areas include East Asia, Eastern Europe, and parts of Central and South America. In the treatment of unresectable or metastatic gastric cancer, chemotherapy leads to a significant survival difference compared to best supportive care (BSC), and could relieve gastric cancer-related symptoms, and improve quality of life (Kucukzeybek et al, 2012)
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