title: Comparative analysis of the efficacy and safety of modified FOLFOX-6 and DCF regimens as first-line treatment in advanced gastric cancer.
abstract: The aim of this study was to retrospectively compare the efficacy and toxicity of the oxaliplatin + 5-fluorouracil (5-FU) + leucovorin (LV) regimen [modified (m)FOLFOX-6] with that of the docetaxel + cisplatin + 5-FU regimen (DCF) in patients with advanced gastric cancer (AGC). A total of 72 patients received DCF (75 mg/m2docetaxel and 75 mg/m2cisplatin on day 1 and 750 mg/m25-FU on days 1-5) every 21 days, whereas 54 patients received mFOLFOX-6 (85 mg/m2oxaliplatin and 400 mg/m2LV as a 2-h infusion, followed by a 5-FU bolus of 400 mg/m2and 2,400 mg/m25-FU as a 46-h continuous infusion) every 14 days. In the DCF arm, 55 (76.4%) of the patients received prophylactic granulocyte colony-stimulating factor (G-CSF), 48-72 h following completion of chemotherapy. The median follow-up of the study was 12.1 months. The overall response rate (ORR) was 37.0% for mFOLFOX-6 and 40.3% for DCF (P=0.72). The median time to progression was 6.5 and 6.2 months in the mFOLFOX-6 and DCF arms, respectively (P=0.70). The median overall survival was 11.4 and 13.5 months in the mFOLFOX-6 and DCF arms, respectively (P=0.72). The rates of hematological toxicity did not differ between the two arms. However, in the subgroup analysis, grade 3-4 neutropenia and febrile neutropenia were significantly more common among patients who had not received G-CSF prophylaxis in the DCF arm. The incidence of grade 3-4 nausea/vomiting and diarrhea were significantly higher in the DCF arm. In conclusion, the present study demonstrated that the efficacy of the mFOLFOX-6 regimen was comparable to that of the DCF regimen in AGC patients. In addition, the benefit of G-CSF prophylaxis in conjunction with the DCF regimen was demonstrated.
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey.
authors.forename: Ilhan
authors.initials: I
authors.lastname: Hacibekiroglu
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey.
authors.forename: Hilmi
authors.initials: H
authors.lastname: Kodaz
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Erdogan
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey.
authors.forename: Esma
authors.initials: E
authors.lastname: Turkmen
authors.affiliation: Department of Radiology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey.
authors.forename: Asim
authors.initials: A
authors.lastname: Esenkaya
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey.
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Onal
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey.
authors.forename: Sernaz
authors.initials: S
authors.lastname: Uzunoglu
authors.affiliation: Department of Medical Oncology, Faculty of Medicine, Trakya University, 22030 Edirne, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Cicin
keywords: docetaxel + cisplatin + 5-fluorouracil regimen; first-line; gastric cancer; oxaliplatin + 5-fluorouracil + leucovorin regimen