Author  
Place of duty  
Title   진행성 위암 환자에 대한 Paclitaxel, Cisplatin, 5-FU 복합 화학요법의 효과 ( Effect of Paclitaxol, Cisplatin, and 5 Flurouracil Chemotherapy in Advanced Stomach Cancer )
Publicationinfo   1997 Jan; 029(04): 648-656.
Key_word   Gastric carcinoma, Paclitaxel, Cisplatin, 5-Fluorouracil
Full-Text  
Abstract   Purpose: Paclitaxel has not been used widely in gastrointestinal cancers. However, a recent phase II report of paclitaxel in patients with esophageal adenocarcinoma has suggested a possible role of paclitaxel for the treatment of advanced gastric carcinoma. A phase II trial was initiated to determine the clinical utility of a 3 drug combination (paclitaxel, cisplatin, and 5-fluorouracil) in patients with advanced gastric carcinoma. Materials and Methods: Eligibility included biopsy-proven inoperable or relapsed adenocarcinoma of the stomach with adequate bone marrow, hepatic, and renal function. Patients received paclitaxel at 175 mg/m2(3 hour infusion) on day 1 followed by cisplatin at 20 mg/m2/day infusion and 5-fluorouracil at 750 mg/m2/day continuous infusion for 5 days. Treatment has been repeated in every 4 weeks. Total 31 patients were enrolled; 7 had relapsed disease after resection and 5-fluorouracil based adjuvant chemotherapy, 5 had previous chemotherapy. Twenty-one patients had measurable disease and 9 were evaluable. Demographics included; median age, 47 years(range, 27~64 years); male: female, 21: 10; median performance status 2(range, 0~4). Results: Major responses occurred in 16/30(53%; 95% confidence interval, 35~71%) patients(2 complete responses, 14 partial responses); 13 of 21(61.9%) patients with measurable disease and 3 of 9(33%) evaluable patients. Median response duration was 17 weeks(range, 8~44+ weeks) and median time to progression was 20 weeks(range, 8~51 + weeks). Median survival was 27 weeks(range, 8~72+ weeks). WHO grade 3~4 toxicities included: neutropenia(61.9%), nausea/vomiting(23.8%), mucositis(19%), and diarrhea (9.5%). Grade 2~3 neurotoxicity, fluid retention syndrome, hypersensitive reaction had occurred in 6, 2, and 1 patients, respectively. There was 1 instance of treatment-related death due to sepsis. Conclusion: This regimen was highly active in advanced gastric carcinoma and had moderate toxicity. However, the response duration was short like other regimens. Considering poor performance status of our patients, this regimen may have strong potential in the neoadjuvant setting.
저 자   김열흥(Yeul Hong Kim),신상원(Sang Won Shin,김병수(Byung Soo Kim),김진호(Jin Ho Kim),김종극(Jong Geuk Kim),목영재(Young Jae Mok),김종석(Jong Seok Kim),송치욱(Chi Wook Song),류호상(Ho Sang Ryu),김준석(Jun Seok Kim),현진해(Jin Hae Hyun)