A Comparison of Weekly DCF versus Standard DCF as First-line Systemic Chemotherapy for Metastatic Gastric Cancer Patients

Objective: In metastatic gastric cancer (MGC), the goals of treatment are palliation and prolongation of overall survival (OS). Systemic chemotherapy, with docetaxel, cisplatin, infusional 5-fluorouracil (DCF) the most preferred regimen, is the mainstay of the treatment. We evaluated the efficacy and tolerability of weekly DCF (wDCF) compared to standard DCF regimen. Methods: We retrospectively reviewed 49 and 32 MGC patients treated with DCF and wDCF regimens as first-line treatment, respectively. The wDCF protocol included 25 mg/m(2) docetaxel, 25 mg/m(2) cisplatin and 750 mg/m(2) infusional 5-FU on day 1, every week. Each cycle was repeated every 3 weeks. Results: The patients in wDCF arm were significantly older (median 54 vs 72.5) and had poor Eastern Cooperative Oncology Group performance status (ECOG PS) than patients in DCF arm (p < 0.001). Progression-free survival was 3 vs 5 months (p=0.75) and OS was 7 vs 9 months in wDCF and DCF arms (p=0.33), respectively. Overall response rate was observed in 28.5 and 31.2% of the patients in DCF and wDCF arms, respectively (p = 0.65). Haematologic toxicities were observed more common in wDCF arm. Conclusion: Weekly DCF is an effective and tolerable regimen and may be an alternative in patients who are elderly and have poor ECOG PS.