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1.
J BUON ; 24(2): 650-655, 2019.
Article in English | MEDLINE | ID: mdl-31128019

ABSTRACT

PURPOSE: Advanced gastric cancer has a dismal prognosis. Platin/5-fluorouracil (PF) combination chemotherapy is the main treatment modality for metastatic gastric cancer patients. Third drug addition to PF is a controversial issue. The aim of this study was to evaluate the predictive role of tumor localization and histopathology on choosing three- or two-drug combination regimens. METHODS: This study was designed as a hospital-based retrospective observational case-series study. A total of 516 patients with advanced gastric cancer has been treated at eight different oncology centers in Turkey between 2006 and 2016. Laboratory results and demographic data were collected and analyzed. RESULTS: The median patient age was 59 years (range 25-85). Proximal intestinal and distal intestinal cancers were found in 357 (69.2 %) and 159 (30.8 %) patients, respectively. 5-fluorouracil (5FU) and cisplatin (PF) and cisplatin+5FU+docetaxel (PFtax, also known as DCF) were administered to 240 (46.5%) and 276 (53.5%) patients, respectively. Median progression free survival (PFS) was 5.0 (95% CI 4.21-5.29) and 8 months (95% CI 7.22-8.77) for PF and PFtax groups, respectively (p=0.000). When tumor localization was used as stratum in PFS survival, PFtax produced significantly higher PFS rates only in distal intestinal type gastric cancer compared to PF (p=0.000). Median overall survival (OS) was 12 (95% CI 9.8-14.2) and 16 months (95% CI 13.6-18.4) for the PF and PFtax groups, respectively (p=0.01). When tumor localization was used as stratum in OS, PFtax showed significantly higher OS rates only in the distal intestinal type gastric cancer compared to PF (p=0.01) Conclusion: Pathology and tumor location in gastric cancer may affect the outcome. Addition of taxanes as a third drug may significantly increase PFS and OS rates only in distal intestinal type gastric cancer but not in patients with proximal type gastric cancer.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Intestines/drug effects , Stomach Neoplasms/drug therapy , Taxoids/administration & dosage , Adult , Aged , Aged, 80 and over , Cisplatin/administration & dosage , Disease-Free Survival , Docetaxel/administration & dosage , Female , Fluorouracil/administration & dosage , Humans , Intestines/pathology , Male , Middle Aged , Prognosis , Progression-Free Survival , Stomach Neoplasms/epidemiology , Stomach Neoplasms/pathology , Treatment Outcome , Turkey/epidemiology
2.
J Gastrointest Cancer ; 41(4): 272-4, 2010 Dec.
Article in English | MEDLINE | ID: mdl-20419482

ABSTRACT

INTRODUCTION: A 51-year-old female was admitted to emergency unit with sudden loss of consciousness. Her blood glucose level from fingertip was 33 mg/dl, and insulin level was 55 (normal range, 4-17 IU). Abdominal ultrasonography revealed pancreatic mass with diffuse liver metastases. Biopsy of liver metastases showed differentiated neuroendocrine carcinoma. METHODS AND RESULTS: Diazoxide and chemotherapy stabilized her glucose level for more than 4 months. However, the disease showed progression, and death occurred 8 months later. CONCLUSION: In conclusion, this case may suggest that biologic behavior may differ from histological behavior in insulinoma and platin-based systemic chemotherapy may provide some benefit in patients those who had diazoxide- and octreotide-resistant tumors.


Subject(s)
Insulinoma/secondary , Liver Neoplasms/secondary , Pancreatic Neoplasms/pathology , Antineoplastic Agents/therapeutic use , Diazoxide/therapeutic use , Fatal Outcome , Female , Humans , Insulinoma/drug therapy , Liver Neoplasms/drug therapy , Middle Aged , Octreotide/therapeutic use , Pancreatic Neoplasms/drug therapy , Vasodilator Agents/therapeutic use
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