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Efficacy and Tolerability of Weekly Docetaxel, Cisplatin, and 5-Fluorouracil for Locally Advanced or Metastatic Gastric Cancer Patients with ECOG Performance Scores of 1 and 2

  • Turkeli, Mehmet (Department of Medical Oncology, Faculty of Medicine, Ataturk University Erzurum) ;
  • Aldemir, Mehmet Naci (Department of Medical Oncology, Faculty of Medicine, Ataturk University Erzurum) ;
  • Cayir, Kerim (Department of Medical Oncology, Faculty of Medicine, Ataturk University Erzurum) ;
  • Simsek, Melih (Department of Medical Oncology, Faculty of Medicine, Ataturk University Erzurum) ;
  • Bilici, Mehmet (Department of Medical Oncology, Faculty of Medicine, Ataturk University Erzurum) ;
  • Tekin, Salim Basol (Department of Medical Oncology, Faculty of Medicine, Ataturk University Erzurum) ;
  • Yildirim, Nilgun (Department of Medical Oncology, Faculty of Medicine, Ataturk University Erzurum) ;
  • Bilen, Nurhan (Department of Internal Medicine, Faculty of Medicine, Ataturk University Erzurum) ;
  • Makas, Ibrahim (Department of Internal Medicine, Faculty of Medicine, Ataturk University Erzurum)
  • Published : 2015.03.04

Abstract

Background: Docetaxel, cisplatin, 5-fluorouracil (DCF) given every three weeks is an effective, but palliative regimen and significantly toxic especially in patients who have a low performance score. Here, we aimed to evaluate the efficacy and tolerability of a weekly formulation of DCF in locally advanced and metastatic gastric cancer patients. Materials and Methods: 64 gastric cancer patients (13 locally advanced and 51 metastatic) whose ECOG (Eastern Cooperative Oncology Group) performance status (PS) was 1-2 and who were treated with at least two cycles of weekly DCF protocol as first-line treatment were included retrospectively. The weekly DCF protocol included $25mg/m^2$ docetaxel, $25mg/m^2$ cisplatin, and 24 hours infusion of $750mg/m^2$ 5-fluorouracil, repeated every week. Disease and patient characteristics, prognostic factors, treatment response, grade 3-4 toxicity related to treatment, progression free survival (PFS) and overall survival (OS) were evaluated. Results: Of the patients, 41 were male and 23 were female; the median age was 63 (29-82) years. Forty-one patients were ECOG-1 and 23 were ECOG-2. Of the total, 81.2% received at least three cycles of chemotherapy. Partial response was observed in 28.1% and stabilization in 29.7%. Overall, the disease was controlled in 57.8% whereas progression was noted in 42.2%. The median time to progression was 4 months (95%CI, 2.8-5.2 months) and median overall survival was 12 months (95%CI, 9.2-14.8 months). The evaluation of patients for grade 3-4 toxicity revealed that 10.9% had anemia, 7.8% had thrombocytopenia and 10.9% had neutropenia. Non-hematologic toxicity included renal toxicity (7.8%) and thrombosis (1.6%). Conclusions: In patients with locally advanced or metastatic gastric cancer who were not candidates for DCF administered every-3-weeks, a weekly formulation of DCF demonstrated modest activity with minimal hematologic toxicity, suggesting that weekly DCF is a reasonable treatment option for such patients.

Keywords

Gastric cancer;locally advanced or metastatic cases;docetaxel;cisplatin;5-fluorouracil;schedule

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