title: Neutropenia predicts better prognosis in patients with metastatic gastric cancer on a combined epirubicin, oxaliplatin and 5-fluorouracil regimen.
abstract: Chemotherapy-induced neutropenia (CIN) reportedly indicated better prognosis for some cancers. We retrospectively analyzed 150 evaluable metastatic gastric cancer (MGC) patients who had received first-line EOF5 (combination regimen of epirubicin, oxaliplatin and 5-day continuous infusion of 5-fluorouracil) treatment. We divided patients into three groups according to the worst grade of CIN: absent group (grade 0), moderate group (grade 1-2) and severe group (grade 3-4). Multivariate analyses of overall survival (OS) proved moderate and severe CIN were important prognostic factors whether regarding CIN as a time-varying covariate (TVC) or not. Compared with absent CIN, hazard ratio (HR) for moderate and severe CIN were 0.31 (95% confidential interval (CI): 0.17-0.55; P < 0.001) and 0.36 (95% CI: 0.20-0.64; P = 0.001) respectively with TVC; and were 0.31 (95% CI: 0.17-0.56; P < 0.001) and 0.34 (95% CI: 0.19-0.61; P < 0.001) respectively without TVC. In progression-free survival (PFS) analyses, moderate and severe CIN showed similar results. In the landmark group (n = 122 patients) analyses with TVC, moderate and severe CIN remained prognostic factors for PFS, while only moderate CIN was prognostic factor for OS. CIN predicted longer OS and PFS in MGC patients treated with first-line EOF5 chemotherapy.
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Rujiao
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Mingzhu
authors.initials: M
authors.lastname: Huang
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Peng
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Si
authors.initials: S
authors.lastname: Sun
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Jun
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Ji
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Chenchen
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Weijian
authors.initials: W
authors.lastname: Guo
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Jin
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Jiliang
authors.initials: J
authors.lastname: Yin
authors.affiliation: Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zhu
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017322:Clinical Trials, Phase II as Topic; D018572:Disease-Free Survival; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced*; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D015251:Epirubicin; D005472:Fluorouracil
keywords: EOF5 regimen; chemotherapy-induced neutropenia; metastatic gastric cancer; overall survival; progression-free survival