The Sensitivity Of Postoperative Adjuvant Chemotherapy For Gastric Adenocarcinoma Detected By CD-DST And Its Application In Individual Therapy

ObjectiveSensitivities of adjuvant chemotherapeutic drugs oxaliplatin,5-FU and irinotecan in patients with gastric adenocarcinoma after gastric cancer surgery were detected by using collagen gel droplet culture drug-sensitivity test(CD-DST).This study aims to explore the guidance of the technology on chemotherapy and clinical feasibility.MethodAccording to the preoperative gastroscope pathology,patients with gastric adenocarcinoma were selected.According to the inclusion and exclusion criteria and postoperative pathology diagnosis(differentiated adenocarcinoma in the stomach,pathological stage III),120 fresh surgical specimens of patients with gastric adenocarcinoma were selected.Among them,70 patients were tested for 5-fluorouracil,oxaliplatin,and irinotecan in vitro using CD-DST technology.The differences in detection success rate and drug sensitivity were observed.Among them,those who were Sensitive to at least one drug in vitro were included in the experimental group and complete chemotherapy guided by the CD-DST test results.Among them,those who are sensitive to 5-fluorouracil were given treatment with tegafur.The 50 patients in the control group did not undergo CD-DST susceptibility testing and were treated conventionally.Through analyzing the test results,we observe the consistency with the clinical efficacy,compare the disease-free survival rate of the two groups of patients after one year.ResultA total of 65 cases of gastric adenocarcinoma were tested successfully in vitro with a detection rate of 92.86%.Of the 65 patients who performed CD-DST in vitro susceptibility testing,21(32.31%)were resistant to the three drugs and 26(40%)were only sensitive to one drug,11(16.92%)were sensitive to both drugs and 4 cases(6.15%)were sensitive to three drugs,and another 3 patients were hyposensitized to the three drugs(4.62%),of which 22 cases were sensitive to oxaliplatin,the sensitivity rate was 33.85%,20 cases were sensitive to 5-fluorouracil,the sensitivity rate was 30.77%,18 cases were sensitive to irinotecan,and the sensitivity rate was 27.69%.The disease-free survival rate of CD-DST-guided chemotherapy in the experimental and control groups was statistically analyzed.The traditional control chemotherapy group(control group)showed a one-year disease-free survival rate of 78%(39/50).CD-DST group according to drug susceptibility results to guide the use of drug results showed that the disease-free survival rate was 93.18%(41/44)a year,the difference was statistically significant(P<0.05).Conclusion1、Through drug sensitivity technology in vitro,we can provide a reference for the selection of a reasonable and effective chemotherapy.2、CD-DST technology used in clinical treatment can improve the efficacy of malignant tumor patients and the level of scientific medication,while avoiding the harm caused by blind chemotherapy3、In multi-drug combination therapy,we can avoid empirical,single drug treatment programs,and select more targeted,reasonable and effective anti-cancer drugs4、CD-DST has avoided the economic losses caused by invalid drugs and reduced the financial burden on patients and the national medical expenses.