Perioperative docetaxel, cisplatin, and 5-fluorouracil compared to standard chemotherapy for resectable gastroesophageal adenocarcinoma

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• 作者：S. Kim^a ; ^b ; ^c ; ¹ ; ^{chkim@chu-besancon.fr} ; S. Paget-Bailly^d ; ¹ ; M. Messager^e ; T. Nguyen^a ; P. Mathieu^f ; N. Lamfichekh^g ; F. Fein^h ; S. Fratté ; ⁱ ; D. Clé ; au^j ; Z. Lakkis^f ; M. Jary^a ; ^c ; N. Sakek^k ; M. Jacquin^b ; A. Foubert^d ; F. Bonnetain^d ; ^l ; C. Mariette^e ; ^m ; F. Fiteni^a ; ^d ; C. Borg^a ; ^b ; ^c
• 关键词：Gastric cancer ; Gastroesophageal cancer ; Preoperative ; Neoadjuvant ; Docetaxel ; Taxane
• 刊名：European Journal of Surgical Oncology (EJSO)
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：43
• 期：1
• 页码：218-225
• 全文大小：275 K
• 卷排序：43

文摘

Even though the perioperative chemotherapy improves the overall survival (OS) compared to surgery alone in patients with a resectable gastroesophageal adenocarcinoma (GEA), prognosis of these patients remains poor. Docetaxel (D), cisplatin (C), and 5-fluorouracil (F) regimen improves OS compared to CF among patients with advanced GEA. We evaluated the potential interest of a perioperative DCF regimen, compared to standard (S) regimens, in resectable GEA patients.MethodsWe identified 459 patients treated with preoperative DCF or S regimens. The primary endpoint was OS. Propensity scores were estimated with a logistic regression model in which all baseline covariates were included. We then used two methods to take PS into account and thus make DCF and S patients comparable. OS analyses were performed with Kaplan–Meier and Cox models in propensity score matched samples, and inverse probability of treatment weighted (IPTW) samples.ResultsIn the propensity score matched sample, the p-value from the log rank test for OS was 0.0961, and the 3-year OS rate was 73% and 55% in DCF and S groups, respectively. The multivariate Cox regression underlined a Hazard Ratio of 0.55 (95% CI 0.27–1.13) for DCF patients compared to S patients. The results from IPTW analyses showed that DCF was significantly and independently associated with OS (HR = 0.52; 95% CI 0.40–0.69).ConclusionsIn this retrospective multicenter, hypothesis-generating study, the propensity score analyses underlined encouraging results in favor of DCF compared to S regimens regarding OS. This promising result should be validated in a phase-3 trial.