{"title":"晚期胃癌的二线化疗:紫杉烷与基于5- fu的治疗。","authors":"Yakup Duzkopru, Ebru Cilbir, Goksen Inanc Imamoglu, Ozlem Dogan, Tulay Eren","doi":"10.29271/jcpsp.2023.07.770","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine the comparative efficacy of taxane-based treatment and 5-FU-based treatment as second-line chemotherapy regimens in advanced gastric cancer patients, as measured by overall survival (OS) and progression-free survival (PFS).</p><p><strong>Study design: </strong>Observational study. Place and Duration of the Study: Department of Medical Oncology, Health Science University Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye, from January 2008 and December 2020.</p><p><strong>Methodology: </strong>Patients aged 18 years and older, diagnosed with gastric cancer, who received at least one line chemotherapy were included. Patients who received FOLFIRI, FOLFOX, and capecitabine in the second-line therapy were grouped as those who received 5-FU-based treatment, while those who received docetaxel and paclitaxel were grouped as those who received taxan-based treatment. The primary outcome measures, OS and PFS, were assessed and compared between the treatment groups using the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 172 patients were included in this analysis, among whom 73 (42.4%) received second-line chemotherapy. Among the patients who received the second-line treatment, 50 (68.5%) were males. The median age of the cohort was 60 years (23-86), with 37 (50.7%) patients falling into the <60 age group. The overall response rates (ORR) were 8% (2/25) in the taxane group and 16.7% (8/48) in the 5-FU-based treatment group. The median overall survival (OS) for all patients receiving second-line therapy was 7.52 months (standard error: 0.97; 95% confidence interval [CI]: 5.62-9.43). Specifically, the median OS was 5.16 months (standard error: 1.07; 95% CI: 3.07-7.25) in the taxane group and 8.02 months (standard error: 1.40; 95% CI: 5.28-10.75) in the group receiving 5-FU-based therapy (p=0.11).</p><p><strong>Conclusion: </strong>The superiority of chemotherapy regimens to each other could not be demonstrated. However, the second-line treatment demonstrated clear superiority over the best supportive care. Therefore, it is recommended that all patients with good performance status (PS) should be offered second-line treatment.</p><p><strong>Key words: </strong>Gastric cancer, Second-line chemotherapy, Taxanes, Treatment efficacy, 5-Fluorouracil.</p>","PeriodicalId":54905,"journal":{"name":"Jcpsp-Journal of the College of Physicians and Surgeons Pakistan","volume":"33 7","pages":"770-774"},"PeriodicalIF":0.7000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Second-line Chemotherapy in Advanced Gastric Cancer: Taxanes <em>versus</em> 5-FU-Based Treatment.\",\"authors\":\"Yakup Duzkopru, Ebru Cilbir, Goksen Inanc Imamoglu, Ozlem Dogan, Tulay Eren\",\"doi\":\"10.29271/jcpsp.2023.07.770\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To determine the comparative efficacy of taxane-based treatment and 5-FU-based treatment as second-line chemotherapy regimens in advanced gastric cancer patients, as measured by overall survival (OS) and progression-free survival (PFS).</p><p><strong>Study design: </strong>Observational study. Place and Duration of the Study: Department of Medical Oncology, Health Science University Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye, from January 2008 and December 2020.</p><p><strong>Methodology: </strong>Patients aged 18 years and older, diagnosed with gastric cancer, who received at least one line chemotherapy were included. Patients who received FOLFIRI, FOLFOX, and capecitabine in the second-line therapy were grouped as those who received 5-FU-based treatment, while those who received docetaxel and paclitaxel were grouped as those who received taxan-based treatment. The primary outcome measures, OS and PFS, were assessed and compared between the treatment groups using the Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 172 patients were included in this analysis, among whom 73 (42.4%) received second-line chemotherapy. Among the patients who received the second-line treatment, 50 (68.5%) were males. The median age of the cohort was 60 years (23-86), with 37 (50.7%) patients falling into the <60 age group. The overall response rates (ORR) were 8% (2/25) in the taxane group and 16.7% (8/48) in the 5-FU-based treatment group. The median overall survival (OS) for all patients receiving second-line therapy was 7.52 months (standard error: 0.97; 95% confidence interval [CI]: 5.62-9.43). Specifically, the median OS was 5.16 months (standard error: 1.07; 95% CI: 3.07-7.25) in the taxane group and 8.02 months (standard error: 1.40; 95% CI: 5.28-10.75) in the group receiving 5-FU-based therapy (p=0.11).</p><p><strong>Conclusion: </strong>The superiority of chemotherapy regimens to each other could not be demonstrated. However, the second-line treatment demonstrated clear superiority over the best supportive care. Therefore, it is recommended that all patients with good performance status (PS) should be offered second-line treatment.</p><p><strong>Key words: </strong>Gastric cancer, Second-line chemotherapy, Taxanes, Treatment efficacy, 5-Fluorouracil.</p>\",\"PeriodicalId\":54905,\"journal\":{\"name\":\"Jcpsp-Journal of the College of Physicians and Surgeons Pakistan\",\"volume\":\"33 7\",\"pages\":\"770-774\"},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Jcpsp-Journal of the College of Physicians and Surgeons Pakistan\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.29271/jcpsp.2023.07.770\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jcpsp-Journal of the College of Physicians and Surgeons Pakistan","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.29271/jcpsp.2023.07.770","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Second-line Chemotherapy in Advanced Gastric Cancer: Taxanes versus 5-FU-Based Treatment.
Objective: To determine the comparative efficacy of taxane-based treatment and 5-FU-based treatment as second-line chemotherapy regimens in advanced gastric cancer patients, as measured by overall survival (OS) and progression-free survival (PFS).
Study design: Observational study. Place and Duration of the Study: Department of Medical Oncology, Health Science University Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkiye, from January 2008 and December 2020.
Methodology: Patients aged 18 years and older, diagnosed with gastric cancer, who received at least one line chemotherapy were included. Patients who received FOLFIRI, FOLFOX, and capecitabine in the second-line therapy were grouped as those who received 5-FU-based treatment, while those who received docetaxel and paclitaxel were grouped as those who received taxan-based treatment. The primary outcome measures, OS and PFS, were assessed and compared between the treatment groups using the Kaplan-Meier method.
Results: A total of 172 patients were included in this analysis, among whom 73 (42.4%) received second-line chemotherapy. Among the patients who received the second-line treatment, 50 (68.5%) were males. The median age of the cohort was 60 years (23-86), with 37 (50.7%) patients falling into the <60 age group. The overall response rates (ORR) were 8% (2/25) in the taxane group and 16.7% (8/48) in the 5-FU-based treatment group. The median overall survival (OS) for all patients receiving second-line therapy was 7.52 months (standard error: 0.97; 95% confidence interval [CI]: 5.62-9.43). Specifically, the median OS was 5.16 months (standard error: 1.07; 95% CI: 3.07-7.25) in the taxane group and 8.02 months (standard error: 1.40; 95% CI: 5.28-10.75) in the group receiving 5-FU-based therapy (p=0.11).
Conclusion: The superiority of chemotherapy regimens to each other could not be demonstrated. However, the second-line treatment demonstrated clear superiority over the best supportive care. Therefore, it is recommended that all patients with good performance status (PS) should be offered second-line treatment.
期刊介绍：
Journal of College of Physicians and Surgeons Pakistan (JCPSP), is the prestigious, peer reviewed monthly biomedical journal of the country published regularly since 1991.
Established with the primary aim of promotion and dissemination of medical research and contributed by scholars of biomedical sciences from Pakistan and abroad, it carries original research papers, , case reports, review articles, articles on medical education, commentaries, short communication, new technology, editorials and letters to the editor. It covers the core biomedical health science subjects, basic medical sciences and emerging community problems, prepared in accordance with the “Uniform requirements for submission to bio-medical journals” laid down by International Committee of Medical Journals Editors (ICMJE). All publications of JCPSP are peer reviewed by subject specialists from Pakistan and locally and abroad.
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