氟尿嘧啶、亚叶酸钙、奥沙利铂和多西紫杉醇（FLOT）方案一线治疗转移性胃癌：单中心经验。

Fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) regimen in the first-line treatment of metastatic gastric cancer: A single-center experience.

机构信息

Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey.

Department of Medical Oncology, Istanbul Basaksehir City Hospital, Istanbul, Turkey.

出版信息

J Cancer Res Ther. 2023 Jan-Mar;19(2):253-258. doi: 10.4103/jcrt.jcrt_672_22.

DOI:10.4103/jcrt.jcrt_672_22

PMID:37006064

Abstract

OBJECTIVE

The median survival time for metastatic gastric cancer that has a poor prognosis is usually shorter than 1 year. The fluorouracil, oxaliplatin, and docetaxel (FLOT) regimen is observed to be effective in the neo-adjuvant treatment of gastric cancer. However, data on the FLOT regimen in metastatic gastric cancer are limited. The current study aims to evaluate the safety and efficacy of the FLOT regimen in metastatic gastric cancer in real life.

STUDY DESIGN

Retrospective study.

PLACE AND DURATION OF STUDY

The study was performed in an Institute of Oncology of a university and included the patients diagnosed between January 2015 and December 2020.

METHODOLOGY

In addition to the clinicopathological data of patients with human epidermal growth factor receptor 2 (HER-2)-negative metastatic gastric cancer, we retrospectively evaluated the survival and treatment-related toxicities. The FLOT regimen (Fluorouracil 2600 mg/m 24 hours continuous intravenous infusion, leucovorin 200 mg/m, oxaliplatin 85 mg/m, and docetaxel 50 mg/m on day 1) every 2 weeks was used in all patients.

RESULTS

The study included 94 patients who were followed up for a median of 11.1 (min-max: 1.5-65.8) months. The number of male patients was 60 (63.4%), and the median age was 58 (min-max: 27-78) years. The primary tumor was located in the stomach (72.3%) and gastroesophageal junction (27.7%). The objective response rate was observed in 64.8% of the patients. The median overall survival was 13.5 (95% CI: 9.2-17.8) months, whereas the progression-free survival was 7 (95% CI: 5.7-8.3) months. The 1-year survival rate was 53.6%. Complete response was detected in 7.4% of the patients. Among grade 3-4 toxicities, neutropenia (44.6%), leukopenia (27.6%), neuropathy (12.7%), and fatigue (9.5%) were the most common observed toxicities.

CONCLUSION

FLOT is a highly active option in the first-line treatment of metastatic gastric cancer, with a favorable safety profile.

摘要

目的

预后不良的转移性胃癌的中位生存时间通常短于 1 年。氟尿嘧啶、奥沙利铂和多西紫杉醇（FLOT）方案在胃癌的新辅助治疗中观察到有效。然而，转移性胃癌中 FLOT 方案的数据有限。本研究旨在评估 FLOT 方案在真实生活中转移性胃癌中的安全性和疗效。

研究设计

回顾性研究。

地点和研究时间

该研究在一所大学的肿瘤研究所进行，纳入了 2015 年 1 月至 2020 年 12 月期间诊断的患者。

方法

除了人表皮生长因子受体 2（HER-2）阴性转移性胃癌患者的临床病理数据外，我们还回顾性评估了生存和治疗相关毒性。所有患者均采用每周 2 次 FLOT 方案（氟尿嘧啶 2600mg/m24 小时持续静脉输注，亚叶酸 200mg/m，奥沙利铂 85mg/m，多西紫杉醇 50mg/m，第 1 天）。

结果

该研究纳入了 94 例患者，中位随访时间为 11.1 个月（最小-最大：1.5-65.8）。男性患者 60 例（63.4%），中位年龄为 58 岁（最小-最大：27-78）。原发肿瘤位于胃（72.3%）和胃食管交界处（27.7%）。患者的客观缓解率为 64.8%。中位总生存期为 13.5 个月（95%CI：9.2-17.8），无进展生存期为 7 个月（95%CI：5.7-8.3）。1 年生存率为 53.6%。患者中有 7.4%达到完全缓解。3-4 级毒性中，最常见的毒性包括中性粒细胞减少（44.6%）、白细胞减少（27.6%）、周围神经病变（12.7%）和疲劳（9.5%）。