title: Effectiveness of doxifluridine (5'-DFUR)/docetaxel against advanced/recurrent gastric cancer showing resistance to various anticancer drug regimens.
abstract: A 58-year-old man was diagnosed as having type 3 gastric cancer (poorly differentiated adenocarcinoma). He underwent total gastrectomy with splenectomy, as well as D3 dissection, and received postoperative chemotherapy combining oral uracil and futrafur (UFT) with cisplatin (CDDP), but results showed recurrence of multiple abdominal lymph node metastases around the aorta. He therefore received various anticancer drug regimens (irinotecan [CPT-11]/CDDP; 1 M tegafur-0.4 M gimeracil-1 M oteracil potassium [TS-1], methotrexate (MTX)/5-fluorouracil); however, final results showed growth of lymph node metastasis and simultaneous worsening of his general condition. The patient then received combined administration of doxifluridine (5'-DFUR)/docetaxel (5'-DFUR, 1000 mg/body [666.7 mg/m(2)], given by consecutive daily administration, orally, for days 1-14; and docetaxel, 80 mg/body [60 mg/m(2)], on day 8, by venous drip, every 3 weeks). Three courses of this regimen resulted in approximately 90% reduction of the abdominal lymph node size, disappearance of the right cervical lymph node metastasis, reductions of the levels of two tumor markers (carcinoembryonic antigen [CEA] and carbohydrate antigen [CA]19-9), and improvement of his general condition. In total, seven courses of the regimen were carried out. The patient died on day 298 after starting this combined regimen and showed a response period of 126 days. The primary toxicity identified was neutropenia (grade 4), as well as other low-grade (grade 1, 2) hematological and nonhematological toxicities. In the field of gastric cancer treatment, especially for patients showing multiple resistance to anticancer drugs, an effective therapy is critically needed.
authors.affiliation: Department of Gastroenterology, Toyosu Hospital, Showa University School of Medicine, 4-1-18 Toyosu, Koto-ku, Tokyo 135-8577, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sato
authors.forename: Ken
authors.initials: K
authors.lastname: Shimada
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nakamachi
authors.forename: Jun
authors.initials: J
authors.lastname: Ushio
authors.forename: Wataru
authors.initials: W
authors.lastname: Yamamoto
authors.forename: Minoru
authors.initials: M
authors.lastname: Kurihara
authors.forename: Masaaki
authors.initials: M
authors.lastname: Matsukawa
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000077143:Docetaxel; D019008:Drug Resistance, Neoplasm; D017809:Fatal Outcome; D005467:Floxuridine / Q000008:administration & dosage*; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D017239:Paclitaxel / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery; D043823:Taxoids
chemical_list: D043823:Taxoids; D005467:Floxuridine; D000077143:Docetaxel; D017239:Paclitaxel; C025034:doxifluridine