학술논문
Safety and efficacy of dose-dense chemotherapy with TCF regimen in elderly patients with locally advanced or metastatic gastric cancer.
Document Type
Academic Journal
Author
Liguigli W; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Tomasello G; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Toppo L; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Poli R; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Lazzarelli S; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Negri F; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Perrucci B; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Curti A; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Brighenti M; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Donati G; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Nazzari M; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Martinotti M; General Surgery Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Vismarra M; General Surgery Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Rovatti M; General Surgery Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.; Passalacqua R; Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
Source
Publisher: Sage Publications Country of Publication: United States NLM ID: 0111356 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2038-2529 (Electronic) Linking ISSN: 03008916 NLM ISO Abbreviation: Tumori Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: To evaluate the efficacy and safety of dose-dense TCF in elderly (≥65 years) compared to younger patients.
Methods: Safety and efficacy data relative to 119 consecutive patients with locally advanced or metastatic gastric cancer treated at our institution and enrolled in different phase II trials were retrospectively collected. All patients were treatment-naive and received docetaxel 70 mg/m2 day 1, cisplatin 60 mg/m2 day 1, l-folinic acid 100 mg/m2 days 1-2, followed by 5-fluorouracil 400 mg/m2 bolus days 1-2, and then 600 mg/m2 as a 22-hour continuous infusion days 1-2, every 14 days, plus pegfilgrastim 6 mg on day 3. Sixty patients (50%) aged ≥65 years received the same schedule with a dose reduction by 30%.
Results: A total of 86% of patients were evaluable for response and all for toxicity. In patients aged ≥65 years, we observed an overall response rate of 51%. Median overall survival was 11.2 (95% confidence interval [CI] 7.3-15.1) and 11.8 months (95% CI 9.2-16.2) in elderly and younger patients, respectively. In the elderly patients, the most frequent grade 3-4 toxicities were neutropenia (13%), leukopenia (7%), thrombocytopenia (18%), anemia (3%), and febrile neutropenia (8%); in the younger patients, neutropenia (56%), leucopenia (31%), thrombocytopenia (22%), anemia (15%), and febrile neutropenia (15%).
Conclusions: Elderly patients can be safely treated with a dose-dense TCF regimen with a 30% dose reduction achieving similar efficacy results as younger patients with lesser toxicity.
Methods: Safety and efficacy data relative to 119 consecutive patients with locally advanced or metastatic gastric cancer treated at our institution and enrolled in different phase II trials were retrospectively collected. All patients were treatment-naive and received docetaxel 70 mg/m2 day 1, cisplatin 60 mg/m2 day 1, l-folinic acid 100 mg/m2 days 1-2, followed by 5-fluorouracil 400 mg/m2 bolus days 1-2, and then 600 mg/m2 as a 22-hour continuous infusion days 1-2, every 14 days, plus pegfilgrastim 6 mg on day 3. Sixty patients (50%) aged ≥65 years received the same schedule with a dose reduction by 30%.
Results: A total of 86% of patients were evaluable for response and all for toxicity. In patients aged ≥65 years, we observed an overall response rate of 51%. Median overall survival was 11.2 (95% confidence interval [CI] 7.3-15.1) and 11.8 months (95% CI 9.2-16.2) in elderly and younger patients, respectively. In the elderly patients, the most frequent grade 3-4 toxicities were neutropenia (13%), leukopenia (7%), thrombocytopenia (18%), anemia (3%), and febrile neutropenia (8%); in the younger patients, neutropenia (56%), leucopenia (31%), thrombocytopenia (22%), anemia (15%), and febrile neutropenia (15%).
Conclusions: Elderly patients can be safely treated with a dose-dense TCF regimen with a 30% dose reduction achieving similar efficacy results as younger patients with lesser toxicity.