Gastric Cancer:S-1联合多西他赛用于III期胃癌D2根治术后辅助化疗的II期可行性研究

2014-06-25 Alexa 译 医学论坛网

背景:S-1辅助化疗是日本II/ III期胃癌">胃癌患者标准治疗。已有研究表明S-1联合多西他赛治疗晚期胃癌患者的反应率和中位总生存期(OS)分别达到56%和14.3个月。之前的II期研究(OGSG0604)——S-1联合多西他赛治疗4个周期——也表现出良好的可行性(78.8%)。本项Ⅱ期研究的目的是在评估S-1联合多西他赛用于III期胃癌D2切除术后辅助化疗6个月的可行性和安全性。 方

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研究内容阅读:

背景:S-1辅助化疗是日本II/ III期胃癌患者标准治疗。已有研究表明S-1联合多西他赛治疗晚期胃癌患者的反应率和中位总生存期(OS)分别达到56%和14.3个月。之前的II期研究(OGSG0604)——S-1联合多西他赛治疗4个周期——也表现出良好的可行性(78.8%)。本项Ⅱ期研究的目的是在评估S-1联合多西他赛用于III期胃癌D2切除术后辅助化疗6个月的可行性和安全性。

方法:D2胃切除术后病理分期为III期的胃癌患者连续2周口服S-1(80-120mgday)并在第1天静脉注射多西他赛(40 mg/m2),每3周重复(1个周期);该治疗开始于手术后45天内,重复进行6个月,然后再继续应用S-1至术后1年。主要终点是S-1联合多西他赛辅助治疗6个月的可行性;次要终点是安全性、PFS、OS和序贯S-1至术后1年的可行性。在统计功效为90%,预期可行性为68%,双侧alpha值为5%的条件下,拒绝50%可行性的样本大小确定为60例。

结果:2010年12月至2012年12月期间,共纳入62例患者,其中男性41例,女性21例,中位年龄63.5岁(年龄范围30~79岁)。患者病理分期为IIIA期32例,IIIB期30例。计划进行6个月治疗的可行性为77.4%(95%CI为65.0-87.1%,P <0.001)。在未发生三级或三级以上发热性中性粒细胞减少症的患者中,19%的患者发生了4级中性粒细胞减少症。>=3级非血液学毒性反应包括10%患者出现乏力,18%食欲减退,2%腹泻和2%恶心,无治疗相关死亡发生。

结论:S-1联合多西他赛Ⅲ期胃癌D2手术后辅助治疗安全可耐受,该方案将会是未来寻求Ⅲ期胃癌D2切除术后最佳辅助化疗III期临床试验的备选方案之一。临床试验信息:UMIN000004440。

原始出处:

Fujitani K1, Tamura S, Kimura Y, Tsuji T, Matsuyama J, Iijima S, Imamura H, Inoue K, Kobayashi K, Kurokawa Y, Shimokawa T, Tsujinaka T, Furukawa H.Three-year outcomes of a phase II study of adjuvant chemotherapy with S-1 plus docetaxel for stage III gastric cancer after curative D2 gastrectomy.Gastric Cancer. 2014 Apr;

Tamura S1, Fujitani K, Kimura Y, Tsuji T, Matsuyama J, Iijima S, Imamura H, Inoue K, Kobayashi K, Kurokawa Y, Furukawa H; Osaka Gastrointestinal Cancer Chemotherapy Study Group.Phase II feasibility study of adjuvant S-1 plus docetaxel for stage III gastric cancer patients after curative D2 gastrectomy.Oncology. 2011


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    2017-07-22 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

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    2016-03-17 hq8888

    9分钟的课程就20块,是蛮贵的,希望能便宜点

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=225191, encodeId=f4e12251916a, content=学习了,谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sat Jul 22 22:43:32 CST 2017, time=2017-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70431, encodeId=25ffe04313d, content=9分钟的课程就20块,是蛮贵的,希望能便宜点, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=55871674107, createdName=hq8888, createdTime=Thu Mar 17 19:45:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25917, encodeId=13c02591e2d, content=学习了,文章结果不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76c01627110, createdName=liliweini, createdTime=Thu Jun 04 13:05:00 CST 2015, time=2015-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784038, encodeId=dcdf1e840386e, content=<a href='/topic/show?id=c421563691' target=_blank style='color:#2F92EE;'>#D2根治术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5636, encryptionId=c421563691, topicName=D2根治术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2e0330, createdName=huangdf, createdTime=Tue Apr 14 12:41:00 CST 2015, time=2015-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21880, encodeId=50242188054, content=提供很好思维方式, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c68e1614119, createdName=windmilL1989, createdTime=Fri Apr 24 17:01:00 CST 2015, time=2015-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710719, encodeId=f77f1e10719f5, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sun Dec 28 20:41:00 CST 2014, time=2014-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16089, encodeId=163116089c7, content=正在学这个课程,非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18751614839, createdName=Aleen, createdTime=Mon Feb 16 15:56:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14938, encodeId=93ca1493834, content=思路很好,学习了 <br> , beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f9c21612116, createdName=tutu159, createdTime=Sun Feb 01 21:19:00 CST 2015, time=2015-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14740, encodeId=f2b814e4016, content=对阅读文献很有启发!, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d8c1612951, createdName=chexr, createdTime=Tue Jan 27 11:36:00 CST 2015, time=2015-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13722, encodeId=581e13e221f, content=多学点,会有提高的, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=13dd1610247, createdName=greenelite, createdTime=Sat Jan 03 17:34:00 CST 2015, time=2015-01-03, status=1, ipAttribution=)]
    2015-06-04 liliweini

    学习了,文章结果不错

    0

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    2015-04-24 windmilL1989

    提供很好思维方式

    0

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    2015-02-16 Aleen

    正在学这个课程,非常好

    0

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    2015-02-01 tutu159

    思路很好,学习了

    0

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    2015-01-27 chexr

    对阅读文献很有启发!

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=225191, encodeId=f4e12251916a, content=学习了,谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Sat Jul 22 22:43:32 CST 2017, time=2017-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=70431, encodeId=25ffe04313d, content=9分钟的课程就20块,是蛮贵的,希望能便宜点, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=55871674107, createdName=hq8888, createdTime=Thu Mar 17 19:45:00 CST 2016, time=2016-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25917, encodeId=13c02591e2d, content=学习了,文章结果不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76c01627110, createdName=liliweini, createdTime=Thu Jun 04 13:05:00 CST 2015, time=2015-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784038, encodeId=dcdf1e840386e, content=<a href='/topic/show?id=c421563691' target=_blank style='color:#2F92EE;'>#D2根治术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5636, encryptionId=c421563691, topicName=D2根治术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2e0330, createdName=huangdf, createdTime=Tue Apr 14 12:41:00 CST 2015, time=2015-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=21880, encodeId=50242188054, content=提供很好思维方式, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c68e1614119, createdName=windmilL1989, createdTime=Fri Apr 24 17:01:00 CST 2015, time=2015-04-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710719, encodeId=f77f1e10719f5, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sun Dec 28 20:41:00 CST 2014, time=2014-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=16089, encodeId=163116089c7, content=正在学这个课程,非常好, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18751614839, createdName=Aleen, createdTime=Mon Feb 16 15:56:00 CST 2015, time=2015-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14938, encodeId=93ca1493834, content=思路很好,学习了 <br> , beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f9c21612116, createdName=tutu159, createdTime=Sun Feb 01 21:19:00 CST 2015, time=2015-02-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=14740, encodeId=f2b814e4016, content=对阅读文献很有启发!, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7d8c1612951, createdName=chexr, createdTime=Tue Jan 27 11:36:00 CST 2015, time=2015-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=13722, encodeId=581e13e221f, content=多学点,会有提高的, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=13dd1610247, createdName=greenelite, createdTime=Sat Jan 03 17:34:00 CST 2015, time=2015-01-03, status=1, ipAttribution=)]
    2015-01-03 greenelite

    多学点,会有提高的

    0

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