Survival analysis of patients with neutropenia and advanced gastric cancer treated with chemotherapy / 中国综合临床

ABSTRACT

Objective To investigate the effect of neutropenia on the quality of life in patients with advanced gastric cancer after chemotherapy.Methods All patients were treated with FOLFOX6 as initial chemotherapy after the diagnosis,14 days as a cycle,the treatment time had 4 cycles.After 4 cycles of chemotherapy,neutrophil levels were measured in all patients.According to CTCAE 4.0 standard.All patients were divided into the non neutropenia reduction group(the non reduction group,17 cases),the mild neutropenia reduction group(the mild reduction group,44 cases)and the severe neutropenia reduction group(the severe reduction group,35 cases).According to RECIST1.1 criteria,the clinical efficacy of the three groups were evaluated.The objective response rate(ORR)and disease control rate(DCR)of the three groups were calculated,and the progression free survival(PFS)and overall survival(OS)were compared among the three groups.Results The difference in clinical efficacy among the non reduction group,the mild reduction group and the severe reduction group was statistically significant(U=15.2314,P=0.0000).The objective response rates in the non reduction group,the mild reduction group and the severe reduction group were 17.65%,56.82%,and 25.71%(χ2=11.7694,P=0.0028),and the disease control rates of the patients in the three group were 47.06%,84.09% and 54.29%,respectively(χ2 = 11.3668,P= 0.0034).The objective response rate and disease control rate in the mild reduction group were significantly higher than those in the non reduction group and the severe reduction group,and the differences among the three groups were statistically significant(P<0.05).At the same time,there were significant differences among the three groups in PFS and OS((F=6.56, 11.11,P<0.05).The PFS and OS in the mild reduction group were significantly higher than those in the non reduction group and the severe reduction group(P<0.05).Conclusion Patients with advanced gastric cancer may have better short-term clinical efficacy and survival time due to mild neutropenia caused by chemotherapy.