***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : A combination of S-1 and cisplatin has been shown to be effective with acceptable safety for the first-line treatment of far-advanced gastric cancer in Japan . This is the first r and omised phase II trial to compare S-1+paclitaxel with S-1+cisplatin in this setting . Methods : Patients with unresectable and /or recurrent advanced gastric cancer were r and omly assigned to receive one of the two regimens : S-1 ( 40 mg m−2 twice daily ) on days 1–14 plus paclitaxel ( 60 mg m−2 ) on days 1 , 8 , and 15 of a 4-week cycle ( S-1+paclitaxel ) or S-1 ( 40 mg m−2 twice daily ) on days 1–21 plus cisplatin ( 60 mg m−2 ) on day 8 of a 5-week cycle ( S-1+cisplatin ) . The primary end point was the response rate ( RR ) . Secondary end points included progression-free survival ( PFS ) , overall survival ( OS ) , and safety . Results : A total of 83 patients were eligible for safety and efficacy analyses . In the S-1+paclitaxel and S-1+cisplatin groups , RRs ( 52.3 % vs 48.7 % ; P=0.74 ) and median PFS ( 9 vs 6 months ; P=0.50 ) were similar . The median OS was similar in the S-1+paclitaxel and S-1+cisplatin groups ( 16 vs 17 months ; P=0.84 ) . The incidence of grade 3 or higher haematological toxicity was 19.0 % with S-1+paclitaxel and 19.5 % with S-1+cisplatin . The incidence of grade 3 or higher non-haematological toxicity was 14.2 % with S-1+paclitaxel and 17.1 % with S-1+cisplatin . Conclusion : S-1+paclitaxel was suggested to be a feasible and effective non-platinum-based regimen for chemotherapy in patients with advanced gastric cancer . Our results should be confirmed in multicenter , phase III-controlled clinical trials OBJECTIVES Advanced gastric cancer ( AGC ) patients have a poor prognosis . The best benefit of chemotherapy is usually achieved by first line setting . Very few studies have compared combination regimens . This study was design ed to compare two combination regimens . METHODS Patients with advanced gastric cancer receiving first line chemotherapy were retrospectively collected , and divided into two groups , receiving DCF ( docetaxel , cisplatin and fluorouracil ) or ECF ( epirubicin , cisplatin and fluorouracil ) regimens . Data were collected for the retrospective analysis in a single center . RESULTS Eighty-six patients were eligible for analysis . Median overall survival ( OS ) was 10.0 months in the ECF group and 11.0 months in the DCF group ( p=0.31 ) . Median progression free survival ( PFS ) for ECF and DCF was equal at 6.0 months . Second line chemotherapy were administered in more than one third of patients . Both regimens had similar toxicity . CONCLUSIONS This is the first study investigating the outcomes of gastric cancer chemotherapy in this region . ECF and DCF regimens have similar efficacy and a similar tolerability profile for first line treatment of advanced gastric cancer . The decision of the first line chemotherapy in advanced gastric cancer could be improved with patient selection according to clinical parameters and molecular markers Abstract Purpose Cisplatin plus 5-fluorouracil has been globally accepted as a st and ard regimen for the treatment for advanced gastric cancer . However , cisplatin has several disadvantages , including renal toxicity and the need for admission . S-1 plus cisplatin has become a st and ard treatment for advanced gastric cancer in East Asia . This phase III study was design ed to evaluate the potential benefits of adding docetaxel to S-1 without a platinum compound in patients with advanced gastric cancer . Methods Patients were r and omly assigned to receive docetaxel plus S-1 or S-1 alone . The docetaxel plus S-1 group received docetaxel on day 1 and oral S-1 on days 1–14 of a 21-day cycle . The S-1 alone group received oral S-1 on days 1–28 of a 42-day cycle . The primary end point was overall survival . Results Of the 639 patients enrolled , 635 were eligible for analysis .  The median overall survival was 12.5 months in the docetaxel plus S-1 group and 10.8 months in the S-1 alone group ( p = 0.032 ) . The median progression-free survival was 5.3 months in the docetaxel plus S-1 group and 4.2 months in the S-1 alone group ( p = 0.001 ) . As for adverse events , neutropenia was more frequent in the docetaxel plus S-1 group , but remained manageable . Conclusion As first-line treatment for advanced gastric cancer , docetaxel plus S-1 significantly improves median overall and progression-free survival as compared with S-1 alone . ( Clinical Trials.gov number : NCT00287768 ) Background Gastrectomy with D2 lymphadenectomy is a st and ard procedure of curative resection for gastric cancer ( GC ) . The aim of this study was to develop a simple and reliable prognostic scoring system for GC treated with D2 gastrectomy combined with adjuvant chemotherapy . Methods A prognostic scoring system was established based on clinical and laboratory data from 579 patients with localized GC without distant metastasis treated with D2 gastrectomy and adjuvant chemotherapy .  Results From the multivariate model for overall survival ( OS ) , five factors were selected for the scoring system : ≥50 % metastatic lymph node rate , positive lymphovascular invasion , pathologic TNM Stage II or III , ≥5 ng/mL preoperative carcinoembryonic antigen level , and < 110 g/L preoperative hemoglobin . Two models were derived using different methods . Model A identified low- and high-risk patients for OS ( P<0.001 ) , while Model B differentiated low- , intermediate- , and high-risk patients for OS ( P<0.001 ) . Stage III patients in the low-risk group had higher survival probabilities than Stage II patients . Both Model A ( area under the curve [ AUC ] : 0.74 , 95 % confidence interval [ CI ] : 0.69–0.78 ) and Model B ( AUC : 0.79 , 95 % CI : 0.72–0.83 ) were better predictors compared with the pathologic TNM classification ( AUC : 0.62 , 95 % CI : 0.59–0.71 , P<0.001 ) . Adjuvant paclitaxel- or oxaliplatin-based or triple chemotherapy showed significantly better outcomes in patients classified as high risk , but not in those with low and intermediate risk . Conclusion A clinical three-tier prognostic risk scoring system was established to predict OS of GC treated with D2 gastrectomy and adjuvant chemotherapy . The potential advantage of this scoring system is that it can identify high-risk patients in Stage II or III who may benefit from paclitaxel- or oxaliplatin-based regimens . Prospect i ve studies are needed to confirm these results before they are applied clinical ly Purpose This r and omized phase II study was conducted to compare the efficacy and safety of paclitaxel with S-1 ( PS ) vs. S-1 in patients with advanced gastric cancer ( AGC ) . Methods Eighty-two ( 82 ) patients were 1:1 r and omly assigned to oral S-1 ( daily for 2 weeks , every 4 weeks ’ cycle ) or S-1 ( daily for 2 weeks , every 4 weeks ’ cycle ) plus paclitaxel ( on day 1 , 8 and 15 of a 4 weeks ’ cycle ) . S-1 was orally administered with a fixed quantity according to body surface area ( BSA ) , while paclitaxel was given 60 mg/m2 i.v . daily through an implanted catheter . The primary endpoint was overall survival ( OS ) . Secondary endpoints included progression-free survival ( PFS ) , overall responsible rates and safety . Results The median OS with PS versus S-1 monotherapy was 14.0 versus 11.0 months ( P = 0.02 ) , survival at 12 months was 61.0 % in the PS group and 46.3 % in the S-1 group . Median PFS was also significantly longer in the PS group ( 6.0 months ) than in the S-1 group ( 4.0 months ) . The overall response rate was determined in 82 evaluable patients , and was significantly higher ( P = 0.04 ) with PS ( 19 patients , 46.3 % ) than with S-1 monotherapy ( 10 patients , 24.4 % ) . PS was well tolerated with no treatment-related deaths , all were grade 3–4 gastrointestinal toxicities , including anorexia , nausea , and diarrhea developed in less than 10 % of the patients . Conclusions Combination chemotherapy of paclitaxel with S-1 is well tolerated and active in AGC patients . Further investigation with comparative trials is needed for confirmation BACKGROUND The recommendation for adjuvant dose-dense chemotherapy in high risk primary breast cancer is heterogeneous among guidelines . Underst and ing the impact on QoL is thereby a crucial factor , especially if the benefit is potentially low . This study aims to assess QoL as a secondary outcome in the prospect i ve r and omized multi-center ADEBAR trial . METHODS QoL was assessed at baseline ( t1 ) , before cycle 4 FEC and cycle 5 EC-DOC ( t2 ) , 4 weeks after chemotherapy ( t3 ) and 6 weeks after radiation ( t4 ) using the European Organization for Research and Treatment for Cancer ( EORTC ) Quality of Life Core Question naire ( QLQ-C30 ) and the Breast Cancer-Specific Module ( QLQ-BR23 ) . RESULTS 1306 patients were enrolled into the ADEBAR trial . 675 were assigned to the FEC and 688 to the EC-DOC arm . After the beginning of treatment , global QoL dropped in both arm by 3 - 4 points . In the EC-DOC arm , QoL dropped further at t3 by 7 points and stayed stable in the FEC arm . 6 weeks after radiation , QoL exceeded baseline in both arms by 6 - 8 points . The differences between treatment arms were strongest at t3 ( 53.0 vs. 49.5 ) but did not reach clinical relevance at any point in time . Physical functioning , nausea and vomiting , fatigue and systemic therapy side effects followed with some minor exceptions similar patterns but showed higher amplitudes . CONCLUSION In conclusion , we could not detect a clinical ly relevant difference between the two treatment arms in global QoL , although the results consistently show that patients on EC-DOC report worse scores during the treatment The incidence rate of gastric cancer is highest in China , where 5 in 10 new cases of stomach cancer across the world are diagnosed . Even though surgical management is the treatment of choice , it is not significantly effective due to advanced stage of the disease at diagnosis and the increased chances of primary tumor recurrence and metastasis to secondary organs . First-line chemotherapy of advanced gastric cancer patients recommend oxaliplatin and docetaxel ; however , not much is known about their usage in Chinese patients . Therefore we retrospectively analyzed 199 cases of advanced gastric cancer ( intestinal , diffuse , and mixed types ) receiving either docetaxel or oxaliplatin-based first-line chemotherapy .  The end-points determined were objective response rate ( ORR , sum of complete and partial responses ) , disease control rate ( DCR , sum of complete response , partial response , and stable disease ) , median progression-free survival ( mPFS ) , and median overall survival ( OS ) time . Both docetaxel and oxaliplatin-based chemotherapy exhibited improved ORR and DCR ; however , the comparison of short-term objective efficacy ( ORR and DCR ) was not statistically significant ( p > .05 ) between the two groups . Our results indicated that PFS and OS of intestinal-type gastric cancer were extended compared with diffuse-type and mixed-type gastric cancer . Adverse reactions were within the control range and after symptomatic treatment were significantly ameliorated . Both docetaxel and oxaliplatin-based chemotherapy thus had a robust treatment outcome and can prospect ively be used as one of the effective chemotherapy regimens for advanced gastric cancer patients in China BACKGROUND S-1-based regimens are commonly used for advanced gastric cancer ( AGC ) in Japan . We performed this trial to evaluate the efficacy and safety of S-1 plus irinotecan ( SIri ) and S-1 plus paclitaxel ( SPac ) as first-line treatments for AGC in order to select the optimal regimen for a subsequent phase III trial . PATIENTS AND METHODS Patients with previously untreated , locally advanced or metastatic measurable gastric adenocarcinoma were r and omly assigned to receive SIri ( irinotecan 80 mg/m(2 ) was administered intravenously ( i.v . ) on day 1 and 15 , while 40 mg/m(2 ) S-1 was orally administered twice daily for three weeks from days 1 - 21 followed by a two-week pause ) or SPac ( paclitaxel 50 mg/m(2 ) was administered i.v . on day 1 and 8 , while 40 mg/m(2 ) 
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However , taxanes may also increase the risks of neutropenia and leucopenia , similar to effects observed in other conventional chemotherapeutic treatments such as oxaliplatin and epirubicin .