Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 28, 2011; 17(8): 1082-1087
Published online Feb 28, 2011. doi: 10.3748/wjg.v17.i8.1082
Paclitaxel based vs oxaliplatin based regimens for advanced gastric cancer
Xiao-Dong Li, Hua Shen, Jing-Ting Jiang, Han-Ze Zhang, Xiao Zheng, Yong-Qian Shu, Chang-Ping Wu
Xiao-Dong Li, Jing-Ting Jiang, Xiao Zheng, Chang-Ping Wu, Department of Oncology, the Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China
Hua Shen, Yong-Qian Shu, Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Han-Ze Zhang, Department of Epidemiology and Biostatistics, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Wu CP designed the research; Li XD and Shen H collected the data; Jiang JT, Zhang HZ, Zheng X and Shu YQ analyzed the data; Li XD and Jiang JT wrote the paper.
Supported by The National Natural Science Foundation of China, No. 30872176, 30950022 and 30972703; and Grants from Jiangsu Province of China, No. K200403, Department of Public Health and Department of Science and Technology (BS2005616)
Correspondence to: Chang-Ping Wu, MD, Professor, Chief, Department of Oncology, the Third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China. wcpjjt@163.com
Telephone: +86-519-68870978 Fax: +86-519-68870978
Received: October 9, 2010
Revised: November 30, 2010
Accepted: December 7, 2010
Published online: February 28, 2011
Abstract

AIM: To compare the efficacy and safety of paclitaxel combined with fluorouracil plus cisplatin (PCF), and oxaliplatin combined with fluorouracil plus leucovorin (FOLFOX-4) regimens for advanced gastric cancer (AGC).

METHODS: Ninety-four patients with AGC were randomly assigned to receive paclitaxel (50 mg/m2 iv) on days 1, 8 and 15, cisplatin (20 mg/m2 iv) and fluorouracil (750 mg/m2 iv) on days 1-5, or oxaliplatin (85 mg/m2 iv) and leucovorin (200 mg/m2 iv) on day 1, followed by bolus fluorouracil (400 mg/m2 iv) and fluorouracil (600 mg/m2 iv) on days 1 and 2. The primary end point was the 1-year survival time.

RESULTS: The overall response rate (ORR) of the patients was 48.0% and 45.5% to PCF and FOLFOX-4, respectively. The disease control rate (DCR) of PCF and FOLFOX-4 was 82.0% and 81.8%, respectively. The median survival times (MSTs) of the patients were 10.8 and 9.9 mo, respectively, after treatment with PCF and FOLFOX-4. The 1-year survival rate of the patients was 36.0% and 34.1%, respectively, after treatment with PCF and FOLFOX-4. No significant difference was observed in ORR, DCR, MST or 1-year survival rate between the two groups. The most common adverse events were anemia, nausea and vomiting, and grade 3/4 alopecia in PCF treatment group, and anemia, grade 1/2 neurotoxic effect and grade 3/4 neutropenia in FOLFOX-4 treatment group.

CONCLUSION: Patients with AGC have a similar response rate to PCF and FOLFOX-4 regimens with a similar survival rate. The PCF and FOLFOX-4 regimens are efficacious and tolerable as a promising therapy for AGC.

Keywords: Paclitaxel, Oxaliplatin, Advanced gastric cancer