Adjuvant Concurrent Chemoradiotherapy (CRT) plus Docetaxel–Cisplatin–Fluorouracil (DCF) versus CRT plus Fluorouracil–Folinic Acid (FUFA) in Stage III Gastric Cancer

Abstract

ABSTRACT Introduction: Adjuvant chemoradiotherapy (CRT) is the optimal management strategy in resectable gastric cancer. There is a debate about the efficacy of more aggressive CRT plus chemotherapy regimens in adjuvant setting. This study aimed to compare the efficacy of adjuvant CRT plus docetaxel–cisplatin–fluorouracil (DCF) versus CRT plus fluorouracil–folinic acid (FUFA) in stage III gastric cancer. Methods: Patients with a diagnosis of stage III gastric cancer treated with adjuvant therapy after curative resection were analyzed. Patients’ disease characteristics and impacts of the regimens on median disease-free survival (DFS) and median overall survival (OS) were analyzed retrospectively. Results: One hundred sixty-one patients (102 in FUFA arm and 59 in DCF arm) with a median age of 56.0 (29–79) were evaluated. In the DCF arm, there were more renal toxicities (31.6% vs 6.4% P < 0.001), emergency department admissions (64.9% vs 23.7%, P < 0.001), and dose reductions/treatment modifications in the DCF arm (51.6% vs 37.2, P < 0.001). The median follow-up was 23 months (1–124) in the FUFA arm and 26.0 months (1–77) in the DCF arm. The median DFS was 25.0 months (%95 CI, 12.7–37.2) in the DCF arm and 17.0 months (%95 CI, 2.6–31.3) in the FUFA arm, P = 0.66. The median OS was 28.0 months (%95 CI, 17.0–38.9) in the DCF arm and 25.0 months (%95 CI, 11.9–36.0) in the FUFA arm, P = 0.70. Conclusion: In conclusion, when compared with FUFA regimen, more aggressive therapy with DCF was more toxic and did not improve OS in adjuvant setting of stage III gastric cancer.