| Objective:To compare the efficacy of SPA and SOX neoadjuvant chemotherapies in the treatment of advanced gastric cancer in order to explore a therapy with better clinical outcomes for patients.Methods:A total of 60 advanced gastric cancer cases (ⅡA-ⅢC) during January 2010 to June 2013 in the Department of Surgical Oncology in First Hospital affiliated to Zhejiang University were analyzed in retrospectively. We set up 30 cases in surgery group (S group) and neoadjuvant chemotherapy group before surgery (NCT group) respectively. Among the latter group, they were divided into two groups according to different chemotherapies SPA and SOX. Then we make comparisons in terms of the radical gastrotomy rates and postoperative complication rates between S Group and NCT Group. And we also research the clinical effects, the preoperative complications and the side effects of chemotherapy between SPA Group and SOX Group. We use SPSS software for data processing and analyzing.Results:The results show that the radical resection rate of S Group and NCT Group were 53.3%(16/30)and 83.3%(25/30)respectively, the comparative difference has statistical significance(x2=6.880, p=0.0321);the postoperative complication rates were 13.3%(4/30)and 16.7%(5/30)respectively, the comparative difference has no statistical significance(x2=4.275, p=0.5105); the clinical total response rate(RR) of NCT group was60%(18/30),SPA group was 53.3%(8/15)and SOX group was 66.7%(10/15),the comparative difference has no statistical significance(5^=0.6957, p=0.7062).Disease control rate(DSR)of both SOX group and SPA group were 100%. Pathologic responses had no statistical significance(x2=2.373, p=0.4986).Between SPA group and SOX group,the RO resection rate was 73.3%(11/15)and 93.3%(14/15)respectively with no statistical significance(x2=2.36, p=0.7062).There are 9 cases of poorly differentiated adenocarcinomas and signet-ring cell carcinomas in SPA group and among which 66.7%(6/9)cases were PR;5 cases of poorly differentiated adenocarcinoma and signet-ring cell carcinoma in SOX group and among which 40%(2/5) were PR. The comparative difference has statistical significance(x2=24.75, p<0.0001).Conclusions:Neoadjuvant chemotherapy in the treatment of advanced gastric cancer is significantly better than surgery alone in terms of decreasing the clinical stage, shrinking tumor burden.Besides, it can improve the radical resection rate in a safe and efficient way, thus, it is preferable for clinical application. Compared SPA with SOX, they are both supposed to be front-line neoadjuvant chemotherapy for advanced gastric cancer and the clinical efficacy is related with Lauren classification. |
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