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Modified-DCF (m-DCF) is a combination chemotherapy regimen consisting of docetaxel, cisplatin, leucovorin, and fluorouracil (5-FU). It is a dose-modified version of the standard DCF (docetaxel, cisplatin, and 5-fluorouracil) regimen, designed to improve the safety profile and reduce the high rates of grade 3/4 toxicities, particularly febrile neutropenia, associated with the original high-dose schedule. The regimen works through multiple mechanisms: docetaxel stabilizes microtubules to inhibit cell division, cisplatin forms DNA cross-links to induce apoptosis, and fluorouracil (potentiated by leucovorin) inhibits thymidylate synthase to disrupt DNA synthesis. It is primarily utilized in the treatment of gastrointestinal malignancies, including gastric, gastroesophageal junction, and esophageal cancers, often as induction therapy or in the metastatic setting.
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