CORRELATION BETWEEN THE EFFECTS OF FIRST-LINE CHEMOTHERAPY AND SURVIVAL TIME FROM SECOND-LINE CHEMOTHERAPY IN PATIENTS WITH ADVANCED GASTRIC CANCER

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Abstract

Background

In advanced gastric cancer (AGC), several prognostic factors for survival time in first-line chemotherapy (1st-CTX) have been reported. However, there are few reports about the relationship between the effects of 1st-CTX and survival time from the start of 2nd-CTX (2nd-MST).

Objectives

To evaluate between the effects of S-1 + CDDP (SP) therapy as 1st-CTX and 2nd-MST in patients with AGC.

Patients and methods

The subjects were 32 patients who were treated with SP therapy as 1st-CTX between October 2002 and December 2010 at our institute. The main selection criteria were as follows: with measurable lesions, treated with Irinotecan (CPT-11) or weekly Paclitaxel (wTXL) as 2nd-CTX. Univariate and multivariate analyses were carried out to examine the correlation between 2nd-MST and the efficacy of SP therapy (progression free survival: 1st-PFS, best tumor response rate: best-RR, time to best response) and other prognostic factors.

Results

The median survival time (1st-MST) and 1st-PFS was 425 and 206 days, respectively. The RR in SP therapy was 66% (PR 21 patients). Best-RR was 30–40/41–50/51–60/61–70/ > 71, %:4/4/3/8/2 patients, respectively. The median to best response time was 73 days. The patient characteristics at the start of 2nd-CTX were as follows: the median age; 63 years, PS; 0/1/2: 9/13/10, histology; intestinal type/diffuse type; 19/13, number of organs with metastases; 1/2/ > 3: 6/16/10, lymph node metastases; yes/no: 20/12, peritoneal dissemination; yes/no: 15/17, 2nd-CTX; CPT/wTXL: 18/14. The 2nd-MST was 173 days. The following factors were correlated with longer 2nd-MST by univariate analyses; age (<65 years), intestinal type, no lymph node metastasis, best-RR over 50% and median time to best response (<73 days). However, there is no significant factor by multivariate analyses.

Conclusions

The effect of SP therapy as 1st-CTX is not prognostic factor of 2nd-MST.

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