The Clinical Analysis Of Efficacy And Safety Of Chemotherapy For Gastric Cancer

Purposes:This retrospective study was performed to evaluate the activity and toxicity of chemotherapy in patients with locally advanced and metastatic gastric cancer.Methods:Advanced gastric cancer patients, who admitted to receive chemotherapy in Department of Medical Oncology of the First Affiliated Hospital of Zhejiang University School of Medicine between January1,2010to December31,2012, were enrolled to this retrospective study. Patients were assessed activity and safety profile after treatment. The efficacy and prognosis related factor including clinical and pathological features, chemotherapy regimen, chemotherapy lines were analyzed.Results:For the first-line chemotherapy with a total of1000cycles, the ORR was35.0%, DCR was83.3%, the median PFS was4.9months (95%CI:4.34-5.46), the median OS was10.4months (95%CI:9.06-11.67).58patients received only first-line chemotherapy, the median OS was6.9months,45patients received1-2line treatment, the median OS was12.3months,19patients received1-3line treatment, the median OS was14.4months,15patients received1-4or1-5line treatment, the median OS was15.5months. The survival time of the patients accept only first-line therapy and2line treatment patients were compared, the result show second-line therapy can significantly improve survival time (P<0.001).In unselected patients, the efficacy of the SPA and SOX was similar. The ORR was30.4%for SOX vs.38.6%SPA (P>0.05), the PFS was4.4months for SOX vs.5.2months for SPA (P=0.13), the OS was10.3months for SOX vs.12.2months for SPA (P=0.223). In signet ring cell carcinoma, poorly differentiated adenocarcinoma, poorly to median differentiated adenocarcinoma cases, The ORR was14.81%for SOX vs.37.4%for SPA (P<0.05), the PFS was4.4months for SOX vs.5.2months for SPA (P=0.685), the OS was10.8months for SOX vs.13.5months for SPA (P=0.291).Cox analysis show sufficient treatment, tumor response, differentiation, first-line PFS, post-progression treatment were independent prognostic factors in patients with advanced gastric cancer.Conclusions:This study suggest that chemotherapy can prolong survival in advanced gastric cancer for first-line treatment as well as for second-and further-line chemotherapy. SPA was associated with similar toxicity compared SOX and was controllable. Therefore SPA is worth to further study. Modern doublet regimens are preferred on the basis of a balanced benefit-to-risk ratio. This study provided the data for different sensitivities of classical cytotoxic treatment for gastric cancer subtypes.