A Clinical Research Of The Therapy Of Late Gastric Carcinoma By Docetaxel Combined With Capecitabine

Objective: Gastric carcinoma is the most common cancer in China, and is also relatively sensitive to chemotherapy. Therefore, chemotherapy is an important method for the treatment of Gastric carcinoma, especially for the patients unsuitable for operation. There are some popular chemotherapeutic schemes such as FAM, MFP, EAP, ELF, FAMTX and so on, but none of them is very effective, and only 30-40% in effect. Comparing with the therapy of non-small cell pulmonary cancer and colocecal carcinoma, there is little progress in that of Gastric carcinoma. So it is in great need of a new medicine or a new chemotherapeutic scheme for Gastric carcinoma. Docetaxel shows a better effect in the treatment of advanced Gastric carcinoma, and capecitabine is also thought highly for its good effect, mild side effect and convenience in application. By now, there is not a standard chemotherapeutic scheme for advanced Gastric carcinoma. We think the docetaxel combined with CAPE can up-regulate TP and enhance the effect to CAPE, there is a synergistic action between them. So we research in the effect and safety of docetaxel combined with CAPE in therapy of advanced gastric cancer and expect find a new way to the standard chemotherapeutic scheme for advanced gastric cancer.Methods: 36 patients were chosen in Dalian Friendship Hospital from Jan 2005 to May 2006. Each patient was diagnosed pathologically, and≥60 in karnofsky scores. They were divided in 2 groups randomly. Patients in groupⅠreceived only docetaxel. In this group 4 cases got their initial treatment, 14 cases got their retreatment. The dose of docetaxel was 100 mg/m2 , ivgtt, repeated in each 21 days. GroupⅡhas 18 cases, and patients in it received docetaxel intravenousely 1-hour drip at 75mg/m2 on day 1 andcapecitabine orally at 1250mg/m2/dose bid on days 1 to 14, repeated every 21 days. In this group 3 cases got their initial treatment, 15 cases got their retreatmen. Evaluated the overall response rate (ORR),median survival time (MST),median time to progression (mTTP) and side effects after 2 cycles.Results: In groupⅠ, there are no cases got CR, 4 cases got PR, and 4 SD, 10 PD, the RR% was 22.2%, intermedial paracmasia was 2.8 months., The confirmed mTTP was 6.2 months and overall survival (OS) was 10.3 months. There's no obvious progress in quality of life according to Karnofsky scores, and raised 10 scores in QOL. In groupⅡ, 2 CR, 8 PR, 5 SD and 3 PD, RR% was 55.6%, intermedial paracmasia was 5 months, , 8 mTTP was 6.2 months, median overall survival (mOS) was10.3 months, and there's 10 scores raised in Karnofsky scores, mean QOL raised 20 scores. There's a significant statistical difference between 2 groups(p<0.01), We can find that combined medication has a higher effect, intermedial paracmasia and intermedial duration, and the intermedial progression interval is evidently prolonged. Therefore the patients in groupⅡhave a better quality of life. The predominant side effects include leucocytopenia, nausea, stomatitis, peripheral neuritis and alopecia. hand-foot syndrome was found in some patients of groupⅡ, most were degreeⅠ~Ⅱ, and tolerable. There is no significant difference in side effects between 2 groups, and no patient was suspended in the therapy for side effect, no patient died of side effects as well.Conclusion: Therapy of advanced gastric cancer by docetaxel combined with capecitabine gives a higher therapeutic effect and milder side effect than former chemotherapeutic schemes, and better than single use of docetaxel as well. The CAPE can be taken orally, conveniently and safely, gives a similar effect to the 5-FU injection, and avoiding the adverse effects of central venous catheterization. So we advise to take the docetaxel combined with capecitabine as one of the standard chemotherapeutic schemes for the advanced gastric cancer..