PhaseⅡstudyofdocetaxel,cisplatinandcapecitabineaspreoperativechemotherapyinresectablegastriccancer

摘要： AIMToinvestigatethefeasibilityofpreoperativedocetaxel,cisplatinandcapecitabine(DCC)inpatientswithresectablegastriccancer.METHODSPatientswithresectablegastriccancerfulfillingtheinclusioncriteria,weretreatedwith4cyclesofdocetaxel(60mg/m2),cisplatin(60mg/m2)andcapecitabine(1.875mg/m2orallyonday1-14,twodailydoses)repeatedeverythreeweeks,followedbysurgery.Primaryendpointwasthefeasibilityandtoxicity/safetyprofileofDCC,secondaryendpointswerepathologicalcompleteresectionrateandpathologicalcompleteresponse(pCR)rate.RESULTSAllofthepatients(51)wereassessableforthefeasibilityandsafetyoftheregimen.Theentirepreoperativeregimenwascompletedby68.6%ofthepatients.GradeⅢ/Ⅳfebrileneutropeniaoccurredin10%ofallcourses.Threepatientsdiedduetotreatmentrelatedtoxicity(5.9%),oneofthem(also)becauseofrefusingfurthertreatmentfortoxicity.Ofthe45patientswhowereevaluableforsecondaryendpoints,fourdevelopedmetastaticdiseaseand76.5%receivedacurativeresection.In3patientsapCRwasseen(5.9%),twopatientsunderwentaR1resection(3.9%).CONCLUSIONFourcoursesofDCCasapreoperativeregimenforpatientswithprimarilyresectablegastriccancerishighlydemanding.Thehighoccurrenceoffebrileneutropeniaisofconcern.Todecreasetheoccurrenceoffebrileneutropeniatheprophylacticuseofgranulocytecolonystimulatingfactor(G-CSF)shouldbeexplored.Acurativeresectionrateof76.5%isacceptable.TheuseofDCCwithoutG-CSFsupportaspreoperativeregimeninresectablegastriccancerisdebatable. ... （共7頁）