Abstract
Chemotherapy is used as an indispensable therapy for advanced gastric cancer. Different chemotherapy regimens have been used for this purpose. Toxicity due to the Chemotherapy drugs is one limiting factor. In this study we aim to compare the efficacy and toxicity of two regimens FOLFOX (leucoverin, 5-fluorouracil and oxaliplatin) and modified DCF (mDCF) (docetaxel, cisplatin, and 5-fluorouracil) in patients with advanced gastric adenocarcinoma. In this analytical cross-sectional study, 47 patients treated with FOLFOX regimen and 57 patients treated with mDCF regimen were recruited, Patients in both groups were compared for demographic findings, response rate, mortality rate, overall survival (OS) and progression free survival (PFS). In FOLFOX and mDCF group, complete response (CR) occurred in 4.3% and 5.3%, partial response (PR) in 42.6% and 29.8%, stable disease in 34% and 52.6% and disease progression in 19.1% and 12.3%, respectively (p=0.25). Overall response rate was 48.9% and 56.1%, respectively. There was no significant difference between two regimens in OS and PFS (p=0.22). mDCF compared to FOLFOX had significantly higher hematologic, gastrointestinal complications, as well as creatinine rise, stomatitis and hair loss, but peripheral neuropathy was significantly lower. The results of current study showed that in patients with advanced gastric adenocarcinoma, FOLFOX regimen compared to mDCF regimen have similar ORR, OS and PFS. Toxicity rate are also lower in FOLFOX group, thus it seems a better regimen for chemotherapy.<br />.
Highlights
Gastric cancer is the fourth most common cancer and the second most common cause of cancer-related death in the world (Ferlay et al, 2015; Haghighi et al, 2016)
In this study we aim to compare the efficacy and toxicity of two regimens FOLFOX and modified DCF in patients with advanced gastric adenocarcinoma. In this analytical cross-sectional study, 47 patients treated with FOLFOX regimen and 57 patients treated with mDCF regimen were recruited, Patients in both groups were compared for demographic findings, response rate, mortality rate, overall survival (OS) and progression free survival (PFS)
Most cases of neuropathy in both groups were grade I and II. In this retrospective cross-sectional study, we evaluated the outcome of patients with advanced gastric adenocarcinoma following treatment with FOLFOX or mDCF regimens
Summary
Gastric cancer is the fourth most common cancer and the second most common cause of cancer-related death in the world (Ferlay et al, 2015; Haghighi et al, 2016). In Iran, gastric cancers are the most common cause of cancer deaths and their incidence are higher than the global average (Zamani et al, 2013). Palliative chemotherapy is a well-known and effective method compared to other supportive treatments in patients with advanced gastric cancer (Huang et al, 1998; Zabaleta, 2012). The overall survival (OS) of advanced gastric cancer is very low; the median OS was 7.5 to 12 months after chemotherapy compared with 3 to 5 months in patients receiving supportive therapy. Overall treatment outcomes have not been satisfactory, chemotherapy has been associated with higher survival and better quality of life compared to supportive treatment (Casaretto et al, 2006; Glimelius et al, 1997; Wagner et al, 2006; Wagner et al, 2010). Meta-analysis studies have shown that combination therapy is highly effective (Iwase et al, 2011; Koizumi et al, 2012; Kim et al, 2011) and the triple-drug regimen is much better than the single-drug or double-drug regimen (Koizumi et al, 2008; Van Cutsem et al, 2006)
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