Combination chemotherapy of irinotecan plus cisplatin for advanced gastric cancer: Efficacy and feasibility in clinical practice

被引：11
作者：
Yoshida M. [1 ]
Boku N. [1 ]
Ohtsu A. [1 ]
Muto M. [1 ]
Nagashima F. [1 ]
Yoshida S. [1 ]
机构：
[1] Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, 6-5-1, Kahiwanoha
来源：
Gastric Cancer | 2001年 / 4卷 / 3期
关键词：
Cisplatin; Gastric cancer; Intestinal type of adenocarcinoma; Irinotecan; Peritoneal dissemination;
D O I：
10.1007/PL00011737
中图分类号：
学科分类号：
摘要：
Background. A previous phase II study showed that a combination of irinotecan (CPT-11) with cisplatin (CDDP) was effective for advanced gastric cancers, but was associated with substantial neutropenia and diarrhea. The aim of this retrospective study was to evaluate the efficacy and feasibility of the combination in clinical practice. Methods. The subjects comprised 65 patients with advanced gastric cancer treated with CPT-11 (70 mg/m2, day 1, day 15) and CDDP (80 mg/m2, day 1) as first-line chemotherapy between April 1993 and March 1999. Patient backgrounds, response rates, response durations, times to progression, and survival rates were investigated retrospectively. Results. The overall response rate and the response rates for measurable metastatic lesions and primary sites were 43% (28/65), 48% (31/64), and 24% (10/42). Leucopenia of grade 4 and diarrhea of grade 3 or 4 were observed in 6 (9%) and 5 (8%) patients, respectively. Among the 19 patients with peritoneal metastasis, leucopenia of grade 4 and diarrhea of grade 3 or 4 were observed in only 1 of the 18 patients who received sufficient oral intake (6%). There were no treatment-related or early deaths within 30 days from the last treatment day. The median survival times of all patients, patients with an intestinal type of adenocarcinoma, and patients with a diffuse type were 365, 472, and 291 days, respectively. Multivariate analysis showed that the histological type of cancer was a significant independent prognostic factor (P = 0.0169). Conclusion. This retrospective study confirmed the efficacy and feasibility of this combination therapy in clinical practice.
引用
收藏
页码：144 / 149
页数：5
相关论文
共 22 条
  • [1] Lacave A.J., Izarzugaza I., Anton Aparicio L.M., Pereda M.V., Marco J.M.G., Buesa J.M., A phase II clinical trial of cis-dichloro diamineplatinum in gastric cancer, Am J Clin Oncol, 6, pp. 35-38, (1983)
  • [2] Moertel C.G., Rubin J., O'Connell M.J., Schutt A.J., Wieand H.S., A phase II study of combined 5-fluorouracil, doxorubicin, and cisplatin in the treatment of advanced upper gastrointestinal adenocarcinomas, J Clin Oncol, 4, pp. 1053-1057, (1986)
  • [3] Preusser P., Wilke H., Achterrath W., Fink U., Lenaz L., Herincke A., Et al., Phase II study with the combination etoposide, doxorubicin, and cisplatin in advanced measurable gastric cancer, J Clin Oncol, 7, pp. 1310-1317, (1989)
  • [4] Findlay M., Cunningham D., Norman A., Mansi J., Nicolson M., Hickish T., Et al., A phase II study in advanced gastric cancer using epirubicin and cisplatin in combination with continuous 5-fluorouracil (ECF), Ann Oncol, 5, pp. 609-616, (1994)
  • [5] Ohtsu A., Shimada S., Yoshida S., Saito H., Seki S., Morise K., Et al., Phase II study of protracted infusional 5-fluorouracil combined with cisplatin for advanced gastric cancer: Report from the Japan Clinical Oncology Group (JCOG), Eur J Cancer, 30 A, pp. 2091-2093, (1994)
  • [6] Kim N.K., Park Y.S., Heo D.S., Suh C., Kim S.Y., Park K.C., Et al., A phase III randomized study of 5-fuorouracil and cisplatin versus 5-fluorouracil, doxorubicin, and mitomycin C versus 5-fluorouracil, alone in the treatment of advanced gastric cancer, Cancer, 71, pp. 3813-3818, (1993)
  • [7] Shimada Y., Shirao K., Ohtsu A., Hyoudou I., Saito H., Yamamichi N., Et al., Phase III study of UFT + MMC versus 5-FU + CDDP versus 5-FU alone in patients with gastric cancer, Proc Am Soc Clin Oncol, 18, (1999)
  • [8] Cullinan S.A., Moertel C.G., Wieand H.S., Moertel C.G., Wieand H.S., O'Connell M.J., Et al., Controlled evaluation of three drug combination regimens versus fluorouracil for therapy of advanced gastric cancer, J Clin Oncol, 12, pp. 412-416, (1994)
  • [9] Kunimoto T., Nitta K., Tanaka T., Uehara N., Baba H., Takeuchi M., Et al., Antitumour activity of 7-ethyl-10-[4-(1-piperidino)-1-piperidino] carbonyloxy-camptothecin, a novel water-soluble derivative of camptothecin, against murine tumours, Cancer Res, 47, pp. 5944-5947, (1987)
  • [10] Andoh T., Ishii K., Suzuki Y., Ikegami Y., Kusunoki Y., Takemoto Y., Et al., Characterization of a mammalian mutant with a camptothecin-resistant DND topoisomerase I, Proc Natl Acad Sci USA, 84, pp. 5565-5569, (1987)
123