Fluoropyrimidine with or without platinum as first-line chemotherapy in patients with advanced gastric cancer and severe peritoneal metastasis: a multicenter retrospective study

BMC Cancer

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[1] 0000 0001 0037 4131, grid.410807.a, Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan;0000 0001 0722 8444, grid.410800.d, Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan;0000 0001 2168 5385, grid.272242.3, Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan;0000 0004 0372 3116, grid.412764.2, Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan;0000 0004 1764 921X, grid.418490.0, Clinical Trial Promotion Department, Chiba Cancer Center, Chiba, Japan;0000 0004 1774 9501, grid.415797.9, Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan;

关键词: Gastric cancer;    Peritoneal metastasis;    Chemotherapy;    Massive ascites;    Inadequate oral intake;   

DOI  :  10.1186/s12885-019-5720-3

来源: publisher

【 摘 要 】

BackgroundThere is no standard first-line chemotherapy for advanced gastric cancer with severe peritoneal metastasis. Although fluoropyrimidine is often used, its efficacy is limited, and it remains unclear whether combination therapy with platinum improves clinical outcomes.MethodsThis retrospective study involved patients at six Japanese academic hospitals between 2010 and 2016. Patients with advanced gastric cancer and severe peritoneal metastasis were included if they had massive ascites and/or inadequate oral intake requiring intravenous nutritional support. We then compared the efficacy and safety of fluoropyrimidine monotherapy with those of fluoropyrimidine/platinum combination therapy.ResultsCompared with the combination therapy group (n = 64), the monotherapy group (n = 65) had worse general health (more patients with elderly age, performance status > 2, and having both massive ascites and inadequate oral intake). Both overall survival (9.0 vs 5.0 months, p < 0.01) and progression-free survival (4.3 vs 2.3 months, p < 0.01) were significantly longer in the combination group, and the significance remained after adjusting for prognostic variables (hazard ratios of 0.47 and 0.41, respectively; p < 0.01). Improvements in ascites and oral intake were also greater in the combination group. Although neutropenia (grade ≥ 3) occurred more frequently with combination therapy, both treatments in this study were tolerable.ConclusionsCombination therapy with fluoropyrimidine and platinum might be more effective than monotherapy with fluoropyrimidine and was tolerable for patients with advanced gastric cancer and severe peritoneal metastasis.

【 授权许可】

CC BY