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영남의대학술지 Vol.24_No.2 Suppl. P.S399-406, Dec. 2007

Original Article

재발 위암환자에서 2차 구제요법제로서의 Docetaxel을 포함한 항암화학요법의 치료 성적 및 부작용

Efficacy and Side Effect of Docetaxel Based Chemotherapy as Second-Line Treatment in Recurrent Gastric Cancer

김세원, 김상운, 송선교
영남대학교 의과대학 외과학교실
책임저자:송선교, 대구광역시 남구 대명 5동 317-1, 영남대학교 의과대학 외과학교실
Tel: (053) 620-3586, Fax: (053) 624-1213
E-mail: sksong@med.yu.ac.kr

December 30, 2007

Abstract

Purpose:To investigate the efficacy and safety of docetaxel based chemotherapy as a second- line treatment in patients with metastatic or recurrent gastric cancer.
Materials and Methods:Between January 2001 and March 2007, 28 patients with recurrent or metastatic gastric cancer were enrolled. The administered doses of decetaxel was 75 mg/m2 on day 1 and 5, cisplatin 60 mg/m2 on day 3, 5-FU 600 mg/m2 over 24 hrs on day 1 to day 5, every 4 weeks. The response was assessed every 2 cycles. The toxicities were evaluated for every course of chemotherapy according to National Cancer Institute-common toxicity criteria (NCI-CTC).
Results:For response rates, 3 (10.7%) partial response, 13 (46.4%) stable disease, and 12 (42.9%) progressive disease, respectively. The overall disease control rate was 57.1%. The median time to progression was 3.0 months (2-8 months). Median overall survival was 8 months (5-11 months). NCI-CTC grade 3 leukocytopenia occurred in 1 cases, grade 3 anemia in 1case and grade 3 nausea/vomiting in 2 cases.
Conclusion:Docetaxel based chemotherapy has a tolerable efficacy with acceptable toxicities in patients with recurrent gastric cancer as a second-line treatment.

Key Words: Docetaxel, Chemotherapy, Gastric cancer

References

1. Moon HS, Kang YS, Kim YS, Park KO, Lee ES, Sung JK, et al. Retrospective study on the therapeutic effects of an etoposide, adriamycin, cisplatin-II(EAP-II) versus an etoposide, leucovorin, 5-furorouracil(ELF) combination chemotherapy in unresectable gastric cancer. J Korean Cancer Assoc. 2003;3:122-7.

2. Pazdur R, Kudelka AP, Kavanagh JJ, Cohen PR, Raber MN. The taxoids: paclitaxel(Taxol) and docetaxel(Taxotere). Cancer Treat Rev 1993 Oct;19(4):351-86.

3. Diaz JF, Andreu JM. Assembly of purified GDP-tubulin into microtubules inducd by taxol and taxotere: reversibility ligand stoichiometry, and competition. Biochemistry 1993 Mar 23; 32(11):2747-55.

4. Ringel I, Horwitz SB. Studies with RP 56976 (Taxotere): a semisynthetic analog of Taxol. J Natl Cancer Inst. 1991 Feb 20;83(4):289-91.

5. Roth AD, Maibach R, Martinelli G, Fazio N, Aapro MS, Pagani O, et al. Docetaxel (Taxotere)- cisplatin (TC): an effective drug combination in gastric carcinoma. Ann Oncol. 2000 Mar;11 (3):301-6.

7. Ridwelski K, Gebauer T, Fahlke J, Kroning H, Kettner E, Meyer F, et al. Combination chemotherapy with docetaxel and cisplatin for locally advanced and metastatic gastric cancer. Ann Oncol. 2001 Jan;12(10):47-51.

8. Murad AM, Santiago FF, Petroianu A, Rocha PR, Rodrigues MA, Rausch M. Modified therapy with 5-fluorouracil, doxorubicin, and methotrexate in advanced gastric cancer. Cancer 1993 Jul 1;72(1):37-41.

9. Glimelius B, Hoffman K, Haglund U, Nyren O, Sjoden PO. Initial or delayed chemotherapy with best supportive care in advanced gastric cancer. Ann Oncol 1994 Feb;5(2):189-90.

10. Cocconi G, DeLisi V, Di Blasio B. Randomized comparison of 5-FU alone or combined with mitomycin and cytarabine (MFC) in the treatment of advanced gastric cancer. Cancer Treat Rep 1982 Jun;66(6):1263-6.

11. Wilke H, Preusser P, Fink U, Achterrath W, Mayer HJ, Stahl M, et al. New developments in the treatment of gastric carcinoma. Semin Oncol 1990 Feb;17(1 suppl2):61-70.

12. Cullinan SA, Moertel CG, Wieand HS, O’Connell MJ, Poon MA, Krook JE, et al. Controlled evaluation of three drug combination regimens versus fluorouracil alone for the therapy of advanced gastric cancer. J Clin Oncol 1994 Feb;12(2):412-6.

13. Kim NK, Park YS, Heo DS, Suh C, Kim SY, Park KC, et al. A phase III randomized study of 5-fluorouracil and cisplatin versus 5-fluorouracil, doxorubicin, and mitomycin C versus 5-fluorouracil alone in the treatment of advanced gastric cancer. Cancer 1993 Jun;71 (12):3813-8.

14. Wils JA, Klein HO, Wagener DJ, Bleiberg H, Reis H, Korsten F, et al. Sequential high-dose methotrexate and fluorouracil combined with doxorubicin: a step ahead in the treatment of advanced gastric cancer. J Clin Oncol 1991 May;9(5):827-31.

15. Webb A, Cunningham D, Scarffe JH, Harper P, Norman A, Joffe JK, et al. Randomized trial comparing epirubicin, cisplatin and fluorouracil versus fluorouracil, doxorubicin, and methotrexate in advanced esophagogastric cancer. J Clin Oncol 1997 Jan;15(1):261-7.

16. Vanhoefer U, Rougier P, Wilke H, Ducreux MP, Lacave AJ, van Cutsem E, et al. Final results of randomized phase III trial of sequential high-dose methotrexate, fluorouracil, and doxorubicin versus etoposide, leucovorin and fluorouracil versus infusional fluorouracil and cisplatin in advanced gastric cancer. J Clin Oncol 2000 Jul;18(14):2648-57.

17. Ohtsu A, Shimada Y, Shirao K, Boku N, Hyodo I, Saito H, et al. Randomized phase III trial of fluorouracil alone versus fluorouracil plus cisplatin versus uracil and tegafur plus mitomycin in patients with unresectable, advanced gastric cancer. J Clin Oncol 2003 Jan 1;21(1):54-9.

18. Bang YJ, Kang WK, Kang YK, Kim HC, Jacques C, Zuber E, et al. Docetaxel 75 mg/min2 is active and well tolerated in patients with metastatic or recurrent gastric cancer: a phase II trial. Jpn J Clin Oncol 2002 Jul;32(7):248-54.

19. Sulkes A, Smyth J, Sessa C, Dirix LY, Vermorken JB, Kaye S, et al. Docetaxel (Taxotere) in advanced gastric cancer: result of a phase II clinical trial. Br J Cancer 1994 Aug;70(2):380-3.

20. Mavroudis D, Kouroussis C, Androulakis N, Kalbakis K, Agelaki S, Kakolyris S, et al. Frontline treatment of advanced gastric cancer with docetaxel and granulocyte colony- stimulating factor (G-CSF): a phase II trial. Am J Clin Oncol 2000 Aug;23(4):341-4.

21. Taguchi T, Sakata Y, Kanamaru R, Kurihara M, Suminaga M, Ota J, et al. Late phase II clinical study of RP56976 (docetaxel) in patients with advanced/recurrent gastric cancer: a Japanese Cooperative Study Group trial (group A) 1998 Oct;25(12):1915-24.

22. Ajani JA, Fodor MB, Tjulandin SA, Moiseyenko VM, Chao Y, Cabral Filho S, et al. Phase II multi-institutional randomized trial of docetaxel plus cisplatin with or without fluorouracil in patients with untreated, advanced gastric, or gastroesophageal adenocarcinoma. J Clin Oncol 2005 Aug 20;23(24):5660-7.