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￭ S-453 ￭
Prognostic Factor Analysis of Triple Combination Chemotherapy in Elderly Metastatic Gastric Cancer Patients
계명대학교 동산의료원 내과
*
이정민, 이강국, 허미화, 김진영, 도영록, 박건욱, 송홍석, 권기영
Background: In elderly cancer patients, current chemotherapy protocols for gastric cancer present high toxicity. The triplet regimen has shown promising results with stomach cancer (Cancer Chemother Pharmacol 67:527, 2011), but we don't know the efficacy and toxicity profiles exactly in the elderly gastric cancer patients with triple regimen chemotherapy. This study were planned to evaluate efficacy and toxicity in patients with elderly metastatic gastric cancer with triple regimen chemotherapy. Methods: In this non-randomized phase II trial, we administered the triplet chemotherapy protocol (taxol 80 mg/m2 i.v. on day 1, 8, cisplatin 30 mg/m2 on day 1, 8 and S1 35mg/m2 bid p.o. on day 1-14 based on a 3-week cycle) to patients aged over 65 years with recurrent or metastatic gastric cancer. Responses were assessed at every 2 cycles combined with toxicity profiles and performance status. Results: From September 2007 to April 2011, total 28 patients (M/F=22/6) were enrolled. The me- dian age was 69 years. The common metastatic lesions were abdominal lymph nodes (57.1%), liver (21.4%). The median number of cycle was 3.5 (range, 1-8). with 50.0% of patients showing disease response: 1 patients (3.6%) showing complete response and 13 (46.4%) showing partial response. Median overall survival (OS) was 7.6 ± 1.46 months. The response rate and OS were not different compare to younger patients. All 28 patients were assessed for safety, laboratory blood test, performance status and body mass index (BMI). This treatment was moderately tol- erated with grade 3/4 neutropenia in 67.9%. Non-hematologic toxicities were grade 3 general weakness in 25.0% of patients. Compare to younger patients, more grade 3/4 neutropenia, anemia and general weakness were observed. Treatment related mortality was 3.6%. Only BMI was corre- lated with OS by cox regression analysis (RR 0.865, 95% CI: 0.751, 0.995, p=0.043). Conclusions: This triple regimen in elderly gastric cancer patients showed relatively high disease response rate and survival duration similar to younger patients, but more frequent neutropenia,and general weakness were seen in elderly patients. Especially in low BMI, triple regimen chemotherapy must be apply with caution.
￭ S-454 ￭
XELOX (capecitabine plus oxaliplatin) in recurrent or metastatic ampullary carcinoma: varying efficacies between intestinal and pancreatobiliary type
1Division of Medical Oncology, 2Division of Gastroenterology, Department of Internal Medicine, 3Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
*
Han Sang Kim
1, Jeong Youp Park
2, Seung Woo Park
2, Si Young Song
2, Sang Jun Shin
1, Sun Young Rha
1, Hyunki Kim
3, Hye Jin Choi
1Background: The objective of this study was to characterize the efficacy and toxicity of the XELOX (capecitabine plus oxaliplatin) in patients with recurrent or metastatic ampullary adenocarcinoma according to histopathologic differentiation. Methods: XELOX was administered in out- patient clinic every 3 weeks according to the following protocol: capecitabine 750 mg/m2 twice a day on days1-14 and oxaliplatin 130 mg/m2 on day 1. For histopathologic differentiation, caudal-related homeobox transcription factor 2 (CDX2), cytokeratin (CK) 7, CK20, mucin (MUC) 1, MUC2, and MUC5AC expression were analyzed using immunohistochemistry. Results: Twenty-one patients were treated. With median 11.7 months of follow-up, median time to progression (TTP) was 7.3 months (95% confidence interval [CI], 6.4-8.2) and median overall survival was not reached. Two patients (9%) achieved complete response and 6 (29%) showed partial response. In subgroup analysis, median TTP was longer among patients with the intestinal type, compared to the pancreatobiliary type (14.3 vs. 7.0 months, p=0.03). The most common grade 3-4 adverse event was neutropenia (27%) and most events were mild. Conclusions: XELOX had favorable efficacy with manageable toxicity for advanced ampullary carcinoma. The intestinal type showed better survival and further investigation for predictive marker are needed.
Table 1. Tumor response to treatment
Response All of patients (N=21)* Intestinal type (N=7) Pancreatobiliary type (N=10)
No (%) No (%) No (%)
CR 2 (9) 1 (14) 0
PR 6 (29) 3 (43) 2 (20)
SD 11 (53) 3 (43) 7 (70)
PD 2 (9) 0 1 (10)
ORR (CR+PR) 8 (38) 4 (57) 2 (20)
Median TTP, months 7.6 (6.0-9.2) 14.3 (4.2-24.3) 7.0 (2.5-11.5)
CR, complete response; PR, partial response; SD, stabgle disease; PD, progressive disease; ORR, objective response rate; TTP, time to progression.
*Four patients not available tissues for immunohistochemistry (one for CR, one for PR, one for SD and one for PD, respectively).
