The Analysis Of The Efficacy And Safety Of Docetaxel Combined With Cisplatin In Locally Advanced Gastric Cancer Patients Who Have Already Completed Perioperative Treatment And Appear Recurrence Or Metastasis

Objective: Gastric cancer is a common malignant tumor in the world.In China,the incidence rate is increasing year by year.As everyone knows,the symptoms of gastric cancer are hidden,so most patients go to the doctor when the already lost the chance of operation.So far,the main method for the treatment of patients with locally advanced gastric cancer is comprehensive treatments based on surgery.But,due to the patients go to the doctor late or their character of pathology,some patients will relapse or metastasis after the completion of the operation and perioperative chemotherapy in 1-3 year,at this time the majority of patients have lost again the opportunity of surgery,to result in the treatments are relatively simple.That time,for the majority of patients will choose to undergo chemotherapy again.But for the locally advanced gastric cancer patients who have already completed perioperative treatment and appear recurrence or metastasis,the course of treatment,the specific adaptation disease has not yet formed a gold standard,the efficacy and safety of that patients also do not have large clinical trials confirmed,so,those are the aim of this study.Further confirming that docetaxel combined with cisplatin chemotherapy for locally advanced gastric cancer patients who have already completed perioperative treatment and appear recurrence or metastasis are effective and safe,providing new theories and methods for better treatment for gastric cancer patients.Methods:Select clinical data of 60 locally advanced gastric cancer patients who have already completed perioperative treatment and appear recurrence or metastasis from September 2012 to September 2015 in The Fourth Hospital of Hebei Medical University.60 cases were enrolled and divided into two groups: test group(treatment group)46 cases and control group(support group)14 cases.The test group received docetaxel + cisplatin: docetaxel 60-75mg/m2;cisplatin 60-75mg/m2,On the first day.Second days to hydration treatment,to minimize side effects of chemotherapy patients,reduce patient discomfort.21 days for 1 cycle.Before the chemotherapy,the patients of test group also need to oral dexamethasone.Short-term curative efficacy,long-term curative efficacy and side effects of the chemotherapy were analyzed.compared the objective response rate(ORR)and disease control rate(DCR)between the test group and control group.Overall survival(OS),and time to progression(TTP)rates were were also need to compared between the two groups.The clinical evaluation index in detail is as follows:1 In test group,to observe patients by Multi-slice spiral CT or MRI before and after chemotherapy,observed the objective response rate(ORR)and disease control rate(DCR).2 In test group,to observe patients by tumor marker before and after chemotherapy,.Analyzing the treatment effectiveness.3 Evaluating patient's condition by taking notes of their symptoms and chief complaint.4 Evaluating the adverse reaction of chemotherapy by follow-up observation.5 In test group,evaluating safety by observing routine analysis of blood,electrolyte,hepatic function and renal function before and after chemotherapy.6 Comparing the overall survival and time to progression between the two groups by peri-operative follow-up observation.Result:1All 60 patients were all followed up.46 cases of the experimental group were followed up for a total of 24.71 months,per capita 5.37 months,median follow-up time was 5.2 months;14 cases of the control group were followed up for a total of 24.71 months,per capita of 4.79 months,median follow-up time of 4.8 month.The test group of 46 cases were all receive the evaluations of chemotherapy curative efficacy.0 cases of completeremission,8 cases of partial remission,18 cases of stable disease,20 cases of disease progression.The overall response rate was 13.04%(8/46),disease control rate was 56.52%(26/46).2 The objective response rate(ORR)was achieved in 13.04% of patients in test group versus 0% in control group(P=0.179);disease control rate(DCR)was achieved in 56.52%% of patients in test group versus14.29% in control group(P=0.006).3 The time to progression of the test group is 3.8-8.2 months;The median time to progression of the test group is 5.2months.The Overall survival of the test group is 5.6-12.8 months The median survival period f the test group is 8.35 months.4 The TTP and OS of test group are all longer than that of control group and the Kaplan-Meier separated in the early time.They all have statistically significant difference(P< 0.05).5 The main adverse reactions in chemotherapy were gastrointestinal and hematologic toxicity reactions,mostly grade 1-2.Symptoms improved after symptomatic treatment and no chemotherapy related deaths.Conclusion:1 Docetaxel combined with cisplatin as the chemotherapy regimen can control the locally advanced gastric cancer patients who have already completed perioperative treatment and appear recurrence or metastasis to a certain extent,the development of the disease.2 Docetaxel combined with cisplatin as the chemotherapy regimen had small toxicity,it was security.3 The locally advanced gastric cancer patients who have already completed perioperative treatment and appear recurrence or metastasis receiving docetaxel combined with cisplatin as the chemotherapy regimen showed tendencies to prolonged survival time and the time to progression,It was a safe and effective treatment mode for those gastric cancer patients.