AIM:To investigate feasibility,morbidity and surgical mortality of a docetaxel-based chemotherapy regimen randomly administered before or after gastrectomy in patients suffering from locally-advanced resectable gastri...AIM:To investigate feasibility,morbidity and surgical mortality of a docetaxel-based chemotherapy regimen randomly administered before or after gastrectomy in patients suffering from locally-advanced resectable gastric cancer.METHODS:Patients suffering from locally-advanced(T3-4 any N M0 or any T N1-3 M0)gastric carcinoma,staged with endoscopic ultrasound,bone scan,computed tomography,and laparoscopy,were assigned to receive four 21 d/cycles of TCF(docetaxel 75 mg/m 2 day 1,cisplatin 75 mg/m 2 day 1,and fluorouracil 300 mg/m 2 per day for days 1-14),either before(Arm A)or after(Arm B)gastrectomy.Operative morbidity,overall mortality,and severe adverse events were compared by intention-to-treat analysis.RESULTS:From November 1999 to November 2005,70 patients were treated.After preoperative TCF(Arm A),thirty-two(94%)resections were performed,85% of which were R0.Pathological response was complete in 4 patients(11.7%),and partial in 18(55%).No surgical mortality and 28.5%morbidity rate were observed,similar to those of immediate surgery arm(P= 0.86).Serious chemotherapy adverse events tended to be more frequent in arm B(23%vs 11%,P=0.07),with a single death per arm.CONCLUSION:Surgery following docetaxel-based chemotherapy was safe and with similar morbidity to immediate surgery in patients with locally-advanced resectable gastric carcinoma.展开更多
背景与目的:已有研究证实,多西他赛联合顺铂(docetaxel plus cisplatin,DP)或多西他赛联合奥沙利铂(docetaxel plus oxaliplatin,DO)治疗晚期胃癌具有较好的疗效。本研究旨在观察周剂量多西他赛联合顺铂与周剂量多西他赛联合奥沙利铂一...背景与目的:已有研究证实,多西他赛联合顺铂(docetaxel plus cisplatin,DP)或多西他赛联合奥沙利铂(docetaxel plus oxaliplatin,DO)治疗晚期胃癌具有较好的疗效。本研究旨在观察周剂量多西他赛联合顺铂与周剂量多西他赛联合奥沙利铂一线治疗晚期胃癌的疗效及不良反应。方法:76例胃癌患者随机分为两组,每组38例,DP组多西他赛35 mg/m2,静脉滴注,第1、8天,顺铂60 mg/m2,静脉滴注,第1天,21 d为1个周期;DO组多西他赛35 mg/m2,静脉滴注,第1、8天,奥沙利铂120 mg/m2,静脉滴注,第1天,21 d为1个周期。结果:DP组总有效率为37%,中位无进展生存期为4.9个月,中位生存期为9.7个月;DO组总有效率为41%,中位无进展生存期为4.4个月,中位生存期为12.3个月。两组的总有效率(P=0.707)、中位无进展生存期(P=0.324)、中位生存期(P=0.581)差异均无统计学意义。两组的3/4级不良反应都是中性粒细胞减少,DP组恶心、呕吐发生率较高(P<0.05),而DO组周围神经病变发生率较高(P<0.05);两组贫血、血小板减少、脱发、腹泻和肝功能损害等不良反应差异均无统计学意义(P>0.05)。结论:DP和DO一线治疗晚期胃癌的疗效及不良反应相仿,值得临床进一步研究。展开更多
文摘AIM:To investigate feasibility,morbidity and surgical mortality of a docetaxel-based chemotherapy regimen randomly administered before or after gastrectomy in patients suffering from locally-advanced resectable gastric cancer.METHODS:Patients suffering from locally-advanced(T3-4 any N M0 or any T N1-3 M0)gastric carcinoma,staged with endoscopic ultrasound,bone scan,computed tomography,and laparoscopy,were assigned to receive four 21 d/cycles of TCF(docetaxel 75 mg/m 2 day 1,cisplatin 75 mg/m 2 day 1,and fluorouracil 300 mg/m 2 per day for days 1-14),either before(Arm A)or after(Arm B)gastrectomy.Operative morbidity,overall mortality,and severe adverse events were compared by intention-to-treat analysis.RESULTS:From November 1999 to November 2005,70 patients were treated.After preoperative TCF(Arm A),thirty-two(94%)resections were performed,85% of which were R0.Pathological response was complete in 4 patients(11.7%),and partial in 18(55%).No surgical mortality and 28.5%morbidity rate were observed,similar to those of immediate surgery arm(P= 0.86).Serious chemotherapy adverse events tended to be more frequent in arm B(23%vs 11%,P=0.07),with a single death per arm.CONCLUSION:Surgery following docetaxel-based chemotherapy was safe and with similar morbidity to immediate surgery in patients with locally-advanced resectable gastric carcinoma.
