Docetaxel Combined With FOLFOX Regimen In Treatment Of Advanced Gastric Cancer Analysis And Safety Evaluation

Objective:To observe the difference efficacy，toxicity and survival time inthe advanced gastric cancer patients treats with docetaxelplus oxaliplatin andfluorouracil/leucovorin or oxaliplatinin combination with fluorouracil/leuco-vorin.Method:We have collected63cases of hospitalized patients withadvanced gastric cancer from February2008to2011Januay.And wererandomly divided into A、B groups.The group A received the docetaxelcombination with oxaliplatin and fluorouracil/leucovorin program,group Bpatients treated with oxaliplatin plus fluorouracil/leucovorin regimen. Theabove two sets of programs are21-day cycle, all patients completed at least4cycles.Results:All63patients were evalued for objective response,Group A(withdocetaxel) had32cases,1case had achieved complete remission(3.1%),partialremission17cases(53.1%),stable in5case(15.6%),and9patients(28.1%)hadprogressed,The total of18patients have been alleviated,the total effective ratereached56.2%.Group B had31cases， The group was no-completeremission,13cases(41.9%) had reached Partial remission,11patients(35.4%)were stable disease,7patients(22.5%)were disease progression,the overallresponse rate reached41.9%after chemotherapy.Therefore，compared the twogroups objectively total efficiency: group A was better than group B,Thatis,docetaxel combination with oxaliplatin and fluorouracil/calcium folinate inthe treatment of advanced gastric cancer was superior to FOLFOX regimen.Butwe obtained P equal0.564by the KS non-parametrictests,that is P greater than 0.05,So the conclution prompted the two groups was no significant difference.Two groups of adverse reactions mainly performed hematologic toxicity andnonhematologic toxicity. Hematologic toxicity performence①The25cases ofGroup A appeared white blood cells decreasing,The overall rate ofincidence78.1%,which I-II was20cases,incidence rate was62.5%,which III-IVwas5cases,incidence rate was15.6%；The incidence78.1%,which I-II was20cases,incidence rate was62.5%,which III-IV was5cases,incidence rate was15.6%；The group of B appeared18cases which the white blood cellsdecreased,the overall rate of incidence58%,which I-II had16cases,the rate ofoccurrence was51.6%,which the III-IV degree had two cases,the rate was6.4%,We caculated P value equal0.68by Chi-square test.This result prompted nosignificant between two groups.②The rate of hemoglobin reducing:the rate ofoccurrence of group A was higher than that group B, which the degree of I-IIhad21cases,the rate of occurrence reached65.6%,III-IV degree had7cases,itaccounted on21.8%；Thus hemoglobin reducing of group B had16cases,whichI-II degree presenced16cases,the rate of occurrence reached51.6%.Weobtained P eqaul0.037by Chi-square test,The conclusion explained statisticalsignificance between two groups.③The chemotherapy of two groups relativelyproduced the lighter impacting on platelet,through the chi-square test,P wasgreater than0.05,We concluded two groups had no significant difference.Inshort，compared the hematologic toxicity of the two groups, The reducing ratewhat white blood cells、granulocyte、hemoglobin、chemotherapy of groupA(docetaxel group)both showed be higher than group B(excluding thedocetaxel group),group A which hemoglobin reduced was significantly higherthan group B，We obtained P less than0.05by the chi-square test,Theresulthas shown statistically significant between the two groups；while the twogroups reducing of white blood cells、granulocytes and platelets have no statistical difference by statistical analysis.Nonhematologic toxicity: Nauseaand vomiting、peripheral nerve paresthesia、diarrhea、oral mucositis,alopecia,and mild liver damage were more common,Which hair loss in group A wassignificantly higher group B,there were statistical difference,the incidence ofthe rest of the nonhematologic toxicity had no significant difference.comparedtwo sets of s-urvival: All63patients with a total of58patients werefollowed-up to survival time. A group32cases,28cases were followed up,4cases missed,The patients survived3.8-25.6months,the median survival timewas10.8months,The1year survival rate was45%.The group of B hadfollow-up to30cases,1cases missed,They survived4.1-23.8months,themedian survival time reached8.7months,The1year survival rate was38%.Kaplan method was used to draw the survival curve，One can see thatpatients of A group what received docetaxel combined with chemotherapy,waslonger in survival time and median living time.But P was equal0.211bylog-rank test,so the result showed two groups had no statistical difference.Conclution:Docetaxel plus oxaliplatin and fluorouracl/leucovorin andoxaliplatinin combination with fluorouracil/leucovorin showed good efficacy intreatment of advanced gastric cancer,had no statistically significant differencebetween the two groups,But The efficiency was better than the latter.Comparedsurvival period of two groups: They both extended living time,and we can seethe survival time of group A was longer than group B from the survivalcurve,But P was less than0.05by log-rank test,so they had no statisticaldifference between two groups.Compared the hematologic toxicity of the twogroups,The ratio what group A(docetaxel group)occured hematologic toxicity(white blood cells、 hemoglobin、 granulocyte、 platelets)was higher thanB(excluding the docetaxel group), the lower hemoglobin group A was weightergroup B, had statistical significance between two groups.They had no significant difference in nonhematologictoxicity excluding phalacrosis.Thereforwe Can be the first choice for containing docetaxel combined with chemo-therapy in treatment of advanced gastric cancer when the patient isgeneralgoodcondition.