[FOLFOX4 regimen versus DP(O)F regimen for advanced gastric cancer].
OBJECTIVE
Currently, there is no standard regimen for advanced gastric cancer. FOLFOX4 regimen [oxaliplatin(L-OHP) with 5-fluorouracil (5-FU)] and DP(O)F regimen [docetaxel (TXT), oxaliplatin (L-OHP)/cisplatin (DDP) with 5-FU] are usually used in treating gastric cancer with satisfactory efficacy. This study was to compare the efficacy, time to disease progression (TTP), overall survival (OS) and toxicity of the two regimens for advanced gastric cancer.


METHODS
Clinical data of 70 chemotherapy-naive patients with advanced gastric cancer were analyzed. Of the 70 patients, 34 were treated with FOLFOX4 regimen, 36 were treated with DP(O)F regimen. The patients in FOLFOX4 group received intravenous infusion of L-OHP (85 mg/m(2)) at Day 1, bolus injection of 5-FU (400 mg/m(2)) at Days 1-2, and continuous intravenous infusion of 5-FU (600 mg/m(2)) for 22 h at Days 1-2; 14 days as one cycle. The patients in DP(O)F group received administration of TXT [20 mg x (m2 x w)(-1)], intravenous infusion of DDP (40 mg/m(2)) at Days 2-3 or L-OHP (100 mg/m(2)) at Day 2, and intravenous infusion of 5-FU (500 mg/m(2)) at Days 1-5; 21 days as one cycle.


RESULTS
The objective response rates were 45.4% in FOLFOX4 group and 52.8% in DP(O)F group (P=0.628). The median TTP was 5.27 months in FOLFOX4 group and 4.70 months in DP(O)F group (P=0.848). The median survival time was 8.97 months in FOLFOX4 group and 12.17 months in DP(O)F group (P=0.095). The most frequent adverse events were nausea, vomit and hematologic toxicities. The occurrence rates of grade III-IV leukopenia and neutropenia were significantly lower in FOLFOX4 group than in DP(O)F group (11.8% vs. 36.1%, P=0.025; 17.6% vs. 41.7%, P=0.038). One patient in FOLFOX4 group died of liver function failure.


CONCLUSIONS
Both FOLFOX4 and DP(O)F regimens are effective in treating advanced gastric cancer. The hematologic toxicities of DP(O)F regimen are worse than those of FOLFOX4 regimen.
Wu
Fang
F
Department of Medical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100021, PR China.
Zhang
Hong-Gang
HG
Ran
Fei-Wu
FW
Zhang
Xiang-Ru
XR
Shi
Yuan-Kai
YK
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D000077150:Oxaliplatin; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D043823:Taxoids / Q000008:administration & dosage
D009944:Organoplatinum Compounds; D043823:Taxoids; D000077150:Oxaliplatin; D000077143:Docetaxel; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil