| Objective: Gastric cancer is one kind of cancer that threat to Chinesepeople. Since the symptoms are not typical of early advanced gastric cancer(AGC), most of the patients (>70%) coming for treatment are advanced gastriccancer. The prognosis of advanced gastric cancer is worse than early gastriccancer. So the development of the treatment model of AGC towards anintegrated treatment model. As the development of chemotherapy models, therole of chemotherapy in AGC is more and more important. MAGIC classicalstudy and recent FNCLCC/FFCD study lay the status of preoperativechemotherapy in AGC, but there isn’t still standard treatment regimenrecommended. Both the epirubicin, cisplatin and5-FU (ECF) regimen andfluorouracil plus cisplatin (FP) regimen have greater toxicity. So neither ofthem can use to Chinese people. Therefore efficiency and low toxicity ofpreoperative chemotherapy regimen is an urgent clinical need. Clinical studieshave demonstrated the activity of oxaliplatin. Oxaliplatin compared tocisplatin have a higher security in gastric cancer. A series of studies in Japanreflect that S-1and capecitabine compared to conventional drugs (5-FU) havemore advantage in terms of efficacy and safety. So to S-1plus oxaliplatin(SOX) regimen is expected to become one of the ideal regimens forpreoperative chemotherapy in gastric cancer. This study focuses on thesecurity issues of SOX regimen for preoperative chemotherapy in AGC,providing theoretical and clinical basis for the comprehensive evaluation ofthe value of this regimen.Methods: According to the standard of our study, we select139cases ofpatients diagnosed AGC in the Fourth Hospital of Hebei Medical Universityfrom November2011to March2013. They are randomly divided into twogroups: preoperative chemotherapy group (group A); postoperative chemotherapy group (group B). The patients received chemotherapy:oxaliplatin at130mg/m2, on day1, intravenously in2hours; S-1at40-60mgfor14days, followed by a7-day rest period within a3-week schedule.Hematology detect during chemotherapy, and monitoring via telephone, andoffering and recovery of follow-up table to collect situation of adversereactions observed in patients. Record the most serious levels of allchemotherapy cycles. Assessment of adverse events according to the CommonTerminology Criteria For Adverse Events (CTCAE)4.0.Result:1There weren’t chemotherapy-related deaths occurring. Hematologicaladverse events in both groups showed leukopenia, neutropenia, anemiaand thrombocytopenia, grade1/2.2Incidence of hematologic adverse events (leucopenia) of Group A less thangroup B. And the difference was statistically significant (P<0.05).Hematologic in grade3/4was lower in both group, the difference of twogroups was not statistically significant (P>0.05).346patients of Group A had received both preoperative and postoperativechemotherapy. The difference of the overall incidence of hematologicaladverse events in the preoperative chemotherapy (34.8%) and ofpostoperative chemotherapy (71.7%), was statistically significant(P<0.05).4Non-hematologic toxicity showed gastrointestinal reactions, dermatitis,fatigue, hand-foot syndrome. The difference in the incidence ofnon-hematologic adverse events of the two groups was not statisticallysignificant (P>0.05).51cases of hearing loss;1case of an outbreak of hepatitis B;1case ofnew-onset cerebral infarction;1case of serious damage to cardiac function;1case of lower extremity arterial in venous thrombosis. All of themimproved after promptly and correctly treatment.Conclusion:1SOX regimen for preoperative chemotherapy in advanced gastric cancer is safe.2Neutropenia, thrombocytopenia, anemia, anorexia, fatigue, sensoryneuropathy were the major treatment-related adverse events of grade3/4.3Hematological toxicities of SOX regimen in pre-operative chemotherapywas smaller, the security is good.4Serious adverse events during chemotherapy can not be ignored, thatremind us of focussing on the individualized chemotherapy. |
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