Medical Oncology

, 31:906 | Cite as

Quality of life in patients with advanced gastric cancer sequentially treated with docetaxel and irinotecan with 5-fluorouracil and folinic acid (leucovin)

  • M. GubanskiEmail author
  • B. Glimelius
  • P. A. Lind
Original Paper


With a median overall survival of only 9–13 months in patients with advanced gastric cancer (GC), the quality of life (QoL) during the palliative treatment remains a key issue. Furthermore, when combinations of two or three drugs are used, the impact on QoL should be carefully evaluated. This was studied within the GATAC trial in patients sequentially treated with docetaxel and irinotecan with 5-fluorouracil and leucovorin (5-Fu/Lv). Patients with previously untreated advanced GC were randomly assigned to start with docetaxel 45 mg/m2 (arm T) or irinotecan 180 mg/m2 (arm C) with bolus and 44 h infusion of 5-Fu/Lv (D1, q2 weeks). After four courses, there was a prescheduled crossover to the alternative regimen for four additional courses. QoL was measured with the EORTC QLQ-C30 questionnaire at the start of the treatment, at crossover and after completing treatment with both regimens. Eighty-one patients were randomized, and 78 patients started treatment. A total of 191 completed QoL questionnaires were collected. There were no statistically significant differences in QoL scores between the two treatment groups and no changes in mean scores during the 16 weeks of treatment. During the last 8 weeks of treatment, a significantly larger portion of patients with radiological response reported sustained or better QoL scores than those with no radiological response (82 vs. 50 %, p = 0.007). Chemotherapy in advanced GC did not affect QoL average scores. Patients with non-responding tumours reported more often a decline in the global QoL score. The concept of the pre-scheduled switch of chemotherapy regimens prior to progression should be further studied in this disease, as it appears effective, tolerable and not to negatively affect QoL.


QoL Quality of life Gastric cancer Palliative chemotherapy Docetaxel Irinotecan 



Financial support from the Swedish Cancer Society (Cancerfonden), Sanofi-Aventis and Pfizer.

Conflict of interest



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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Oncology and PathologyKarolinska IntitutetStockholmSweden
  2. 2.Department of Radiology, Oncology and Radiation ScienceUniversity of UppsalaUppsalaSweden
  3. 3.Centre for Clinical Research SörmlandUppsala UniversityUppsalaSweden

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