Analysis of clinical efficacy and safety of docetaxel or irinotecan combined with oxaliplatin and S-1 in the treatment of advanced gastric cancer / 重庆医学

ABSTRACT

Objective To observe the clinical efficiency and safety of docetaxel(TXT) or irinotecan(CPT-11) combined with oxaliplatin(L-OHP) and S-1 in the treatment of advanced gastric cancer.Methods Totally 62 cases of patients with stage Ⅲ B-Ⅳ advanced gastric cancer in the Department of Gastrointestinal Surgery of our hospital were collected from 1st January 2010 to 1st March 2016,and were divided into two groupsTXT combined with L-OHP and S-1 group (modified DCF group,33 patients) and CPT-11 combined with L-OHP and S-1 group (modified ICF group,29 patients).All patients in the two groups were completed at least 1 cycle of chemotherapy until disease progression or intolerable toxicity.At the end of chemotherapy,the curative effects,untoward reactions and effects of surgery after neoadjuvant chemotherapy treatment were compared and analyzed.Results The objective response rate (ORR) in the modified DCF group(60.6％) was higher than that in the modified ICF group (51.7％),while no statistically significant difference was found in short-term effects between the two groups (Z=-0.837,P=0.403).There was no statistically significant difference in the incidences of main untoward reactions,including gastrointestinal reaction,myelosuppression,neurotoxicity,alopecia and liver function abnormal,between the two groups (P＞0.05).The radical resection rate of the modified DCF group and the modified ICF group after neoadjuvant chemotherapy was 66.7 ％ and 62.1 ％ respectively,the difference between the two groups was not statistically significant (x2=0.143,P=0.706).After neoadjuvant chemotherapy,the main postoperative complications were anastomotic leakage,anastomotic obstruction,abdominal infection,pulmonary infection,incision infection and gastric motility disorder,and no statistically significant difference was found in the incidence of postoperative complications between the two groups (P＞0.05).The was no statistically significant difference in quality of life after chemotherapy between the two groups (P＞0.05).Conclusion TXT or CPT-11 combined with L-OHP and S-1 has similar efficacy in the treatment of advanced gastric cancer,which could reduce tumour size,improve radical resection rate.Furthermore,untoward reactions of the two neoadjuvant chemotherapy protocols are almost the same,and can be tolerated.It is worthy of further research and application.