Docetaxel, Cisplatin, 5-FU Combination Chemotherapy as a First-Line Treatment in Patients with Advanced Gastric Cancer

Kim, Bu Kyung; Park, Moo In; Park, Seun Ja; Kim, Kyu Jong; Moon, Won; Jeong, Su Hyeon; Kim, Hye Soo; Nam, Sung Jin

Abstract

BACKGROUND/AIMS
This study investigated the efficacy and safety of docetaxel/cisplatin/5-fluorouracil (DCF) combination chemotherapy as a first-line treatment in patients with advanced gastric cancer.
METHODS
The study enrolled 48 patients diagnosed with unresectable pathologically proven gastric cancer who received DCF combination chemotherapy between April 2006 and August 2009. The dose administered was docetaxel 75 mg/m2 for 1 h and cisplatin 75 mg/m2 for 90 min on day 2, and 5-FU 750 mg/m2 for 24 h on days 1-5, every 3 weeks. The response was assessed every three cycles. The toxicity was evaluated for every chemotherapy course according to the National Cancer Institute (NCI) toxicity criteria ver. 2.0.
RESULTS
The median age of the patients was 58 years (range 31-78 years). The median overall survival was 11.5 months (2.3-28.2 months) and the median time to progression was 5.5 months (0.3-18.9 months). No complete remission occurred. Of the patients, 56% achieved a partial response, 21% stable disease, and 10% progressive disease. The overall response rate was 56%. During a total 292 cycles, anemia worse than NCI toxicity grade 3 occurred in 2%, leukopenia in 33.1%, neutropenia in 67.1%, and thrombocytopenia in 4.4%. Neutropenic fever occurred in 33 cycles (11.3%), dose reduction due to side effects in 165 cycles (56.5%), and a regimen change due to side effect in five cycles (1.7%).
CONCLUSIONS
Combination chemotherapy with docetaxel, cisplatin, and 5-FU is efficacious, but has relatively high toxicity. A DCF protocol that maximizes its efficiency, while minimizing toxicity, would be more useful as a first-line treatment in patients with advanced gastric cancer.