BACKGROUND Fluoropyrimidine plus platinum, followed by paclitaxel (PTX) plus ramucirumab is a recommended treatment strategy for advanced gastric cancer (AGC). We investigated how peripheral neuropathy (PN), induced by platinum in first-line chemotherapy, affected the tolerability of second-line chemotherapy with PTX (2nd-PTX). METHODS The subjects were AGC patients who received second-line chemotherapy with PTX (2nd-PTX) after the failure of platinum-based chemotherapy between March 2015 and June 2018. We retrospectively reviewed PN severity, and dose reduction and/or discontinuation due to PN during 2nd-PTX, and compared the cumulative incidence of grade 2 PN between the two groups according to first-line chemotherapy containing oxaliplatin (L-OHP) or cisplatin (CDDP). RESULTS The L-OHP and CDDP groups consisted of 50 patients each. PN severity before 2nd-PTX was grade 1/2 in 46/12% of patients in the L-OHP group, and 100/0% in the CDDP group. The worst grades of chemotherapy-induced PN during 2nd-PTX were grades 1/2/3 in 40/34/14% of patients in the L-OHP group, and 36/18/0% in the CDDP group. Median time to grade 2 PN after starting second-PTX was 2.5 months in the L-OHP group and 8.6 months in the CDDP group (hazard ratio 3.34, p = 0.002). The frequencies of a PN-related dose reduction and/or discontinuation of PTX were 18% in the L-OHP group and 8% in the CDDP group (p = 0.234). CONCLUSIONS The severity of PN and tolerability of 2nd-PTX may be affected by first-line chemotherapy with L-OHP or CDDP for AGC.

中文翻译：

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一线化疗中铂诱导的周围神经病变对紫杉醇二线化疗对晚期胃癌的影响。

背景技术氟嘧啶加铂，然后紫杉醇（PTX）加雷莫西单抗是晚期胃癌（AGC）的推荐治疗策略。我们调查了一线化疗中铂诱导的周围神经病变（PN）如何影响PTX（2nd-PTX）二线化疗的耐受性。方法研究对象为2015年3月至2018年6月铂类化疗失败后接受PTX二线化疗（2nd-PTX）的AGC患者。我们回顾性回顾了PN的严重程度，剂量减少和/或由于PN停药在第二次PTX期间，根据含奥沙利铂（L-OHP）或顺铂（CDDP）的一线化疗比较了两组之间2级PN的累积发生率。结果L-OHP和CDDP组各有50例患者。L-OHP组中2nd-PTX之前的PN严重程度为1/2/1/2级，而CDDP组为100/0％。在第二次PTX期间，化疗诱导的PN的最差等级是L-OHP组中40/34/14％的患者中1/2/3级，而CDDP组中36/18/0％。L-OHP组开始第二次PTX后达到2级PN的中位时间为2.5个月，而CDDP组为8.6个月（危险比3.34，p = 0.002）。PN相关剂量减少和/或PTX停药的频率在L-OHP组中为18％，在CDDP组中为8％（p = 0.234）。结论一线化疗联合L-OHP或CDDP进行AGC可能会影响PN的严重程度和2nd-PTX的耐受性。在第二次PTX期间，化疗诱导的PN的最差等级是L-OHP组中40/34/14％的患者中1/2/3级，而CDDP组中36/18/0％。L-OHP组开始第二次PTX后达到2级PN的中位时间为2.5个月，而CDDP组为8.6个月（危险比3.34，p = 0.002）。PN相关剂量减少和/或PTX停药的频率在L-OHP组中为18％，在CDDP组中为8％（p = 0.234）。结论一线化疗联合L-OHP或CDDP进行AGC可能会影响PN的严重程度和2nd-PTX的耐受性。在第二次PTX期间，化疗诱导的PN的最差等级是L-OHP组中40/34/14％的患者中1/2/3级，而CDDP组中36/18/0％。L-OHP组开始第二次PTX后达到2级PN的中位时间为2.5个月，而CDDP组为8.6个月（危险比3.34，p = 0.002）。PN相关剂量减少和/或PTX停药的频率在L-OHP组中为18％，在CDDP组中为8％（p = 0.234）。结论一线化疗联合L-OHP或CDDP进行AGC可能会影响PN的严重程度和2nd-PTX的耐受性。PN相关剂量减少和/或PTX停药的频率在L-OHP组中为18％，在CDDP组中为8％（p = 0.234）。结论一线化疗联合L-OHP或CDDP进行AGC可能会影响PN的严重程度和2nd-PTX的耐受性。PN相关剂量减少和/或PTX停药的频率在L-OHP组中为18％，在CDDP组中为8％（p = 0.234）。结论一线化疗联合L-OHP或CDDP进行AGC可能会影响PN的严重程度和2nd-PTX的耐受性。