Li JW, Huang CZ, Yuan JH, Chen QH. Comparison of efficacy of modified EOX and FOLFIRI regimens in treatment of metastatic gastric cancer.
Shijie Huaren Xiaohua Zazhi 2016;
24:1866-1873. [DOI:
10.11569/wcjd.v24.i12.1866]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the efficacy and toxicity of modified epirubicin, oxaliplatin, and capecitabine (EOX) and irinotecan, 5-fluorouracil, and leucovorin (FOLFIRI) regimens in metastatic gastric cancer patients.
METHODS: A total of 105 patients with advanced gastric carcinoma were randomly divided into either an EOX group (n = 55) or a FOLFIRI group (n = 50). The EOX group was given epirubicin 50 mg/m2 iv on day one, oxaliplatin 85 mg/m2 iv on day 1 and capecitabine at a twice-daily dose of 625 mg/m2 po for 2 wk, which was repeated every 3 wk. Efficacy was analyzed at least every 2 cycles along with adverse reactions. Patients in the FOLFIRI group received irinotecan 180 mg/m2 on day 1, leucovorin 400 mg/m2 as two-hour infusion and 5-fluorouracil 400 mg/m2 as a bolus, on day 1 and day 2 followed by 1200 mg/(m2•d) as 22 h continuous infusion regimen every 2 wk. Efficacy was analyzed at least every 4 cycles along with adverse reactions.
RESULTS: The objective response rates (ORR) in the modified EOX group and FOLFIRI group were similar (40.0% vs 48.0%, P = 0.409). The progression-free survival (PFS) rates in the first-line modified EOX group and FOLFIRI group were 7.3 mo and 8.4 mo (P = 0.07), respectively. The PFS rates in the second-line modified EOX group and FOLFIRI group were 2.4 mo and 3.4 mo (P = 0.098), respectively. The overall survival (OS) in the modified EOX group and FOLFIRI group was 13.5 mo and 14.3 mo (P = 0.40), respectively. The risk ratio (HR) of the modified EOX group to the FOLFIRI group was 0.810 (95%CI: 0.501-1.163) and less than 1.25, which suggests that non-inferiority was established. The incidence rates of grades III-IV neutropenia, thrombocytopenia, anemia and stomatitis in the modified EOX group were significantly lower than those in the FOLFIRI group (P < 0.05). The rates of dose reduction and dose delay in the modified EOX group were significantly lower than those in the FOLFIRI group (P < 0.001).
CONCLUSION: The modified EOX regimen is safe and feasible, and has the potential to become a standard regimen against advanced gastric cancer.
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