Perioperative docetaxel, cisplatin, and 5-fluorouracil (DCF) for locally advanced esophageal and gastric adenocarcinoma: a multicenter phase II trial
Autor: | Martin Chasen, M.P. Thirlwell, Steven Ades, Victoria Marcus, Lorenzo E. Ferri, Thierry Alcindor, M. Hickeson, G. Artho |
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Rok vydání: | 2012 |
Předmět: |
Adult
Male medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Urology Phases of clinical research Docetaxel Adenocarcinoma Gastroesophageal Junction Adenocarcinoma Young Adult Stomach Neoplasms Antineoplastic Combined Chemotherapy Protocols medicine Humans Perioperative Period Aged Aged 80 and over Chemotherapy business.industry Hematology Perioperative Middle Aged Esophageal cancer medicine.disease Combined Modality Therapy Chemotherapy regimen Tumor Burden Surgery Regimen Oncology Female Taxoids Fluorouracil Cisplatin business medicine.drug |
Zdroj: | Annals of Oncology. 23:1512-1517 |
ISSN: | 0923-7534 |
Popis: | Background Although perioperative chemotherapy for esophagogastric adenocarcinoma (ADC) improves survival, the overall poor prognosis suggests that further refinement of treatment is required. Docetaxel, cisplatin, and 5-fluorouracil (5-FU) (DCF) is effective for metastatic ADC of the upper gastrointestinal (GI) tract; we thus sought to investigate the efficacy of this regimen in patients with resectable disease. Patients and methods Patients with resectable ADC of the upper GI tract received DCF [docetaxel (Taxotere) 75 mg/m2 I.V. day 1, cisplatin 75 mg/m2 I.V. day 1, 5-FU 750 mg/m2 continuous infusion for 120 h, every 3 weeks] for three cycles before and after resection. Primary end point was complete resection; secondary end points were response, toxicity, surgical morbidity, and overall survival. Results Forty-three patients with ADC of the esophagus (11), gastroesophageal junction (25), or stomach (7) started treatment and 86% completed all preoperative cycles with grade 3–4 toxicity arising in 47%. Metabolic response to chemotherapy (reduction in maximal standard uptake value >35%) was achieved in 25/33 (76%) patients. Surgery was carried out in 41/43 and complete resection was achieved in all 41 patients with pathologic complete response in 4/41. Postoperative chemotherapy was started in 29 patients and completed in 24. Three-year overall survival was 60%. Conclusion Perioperative DCF is a tolerable and highly effective regimen for the treatment of esophagogastric ADC. |
Databáze: | OpenAIRE |
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