| Background and objective: Gastric cancer is one of the most common malignant tumors of digestive system.The main treatment is surgery.Only part of the patients have the opportunity of completed cure.In 2006 a perioperative chemotherapy phase III clinical MAGIC study showed that preoperative and postoperative application of ECF have better Progression Free Survival time and Overall Survival time than surgery alone patients.The results of this study laid the status of perioperative chemotherapy.The results of a 2007 ACTS-GC study reported in Japan showed that after radical resection D2 surgery of gastric cancer,patients who use S-1 for chemotherapy than surgery alone have a prolonged trend on Overall Survival time and Relapse-Free survival time.Paclitaxel is a commonly used drug in treating gastric cancer.Researchs show that patients use paclitaxel combined with S-1for advanced gastric cancer showed better curative effect.We found that paclitaxel combined with S-1 and oxaliplatin combined with S-1 is commonly used for treatment of gastric cancer in clinical,and paclitaxel is used in patients with high risk factors.So this research make comparison between TS(Paclitaxel plus S-1)and SOX(Oxaliplatin plua S-1)for chemotherapy assisted chemotherapy after surgey,the usage of Chinese Herbal Medicineand,recurrence and metastasisthe adverse cnd reactions after treatment.Methods: Census the clinical data of patients with chemotherapy of TS or SOX in The Second Affiliated Hospital of Dalian Medical University during September,2009 to October,2015,then analyze retrospectively.And were followed up by clinical data or telephone calls.We use SPSS22.0 to analyse the data,aiming at study the difference of RFS and OS rate,the usage of Chinese Herbal Medicineand,recurrence and stasisthe metaadverse cnd reactions of the two chemotherapy regimens.Results: 1.There were 77 patients in total,including TS group(n = 24)and SOX group(n = 53),77 patients completed 407 chemotherapy cycles in total,with an average of 5.3 cycles.All patients' cycles of chemotherapy are between 3-8,77 patients' 1 years RFS rate and OS rates were 87%,96.1%,2 year RFS rate and OS rates were 70.5%,77.5%,3 year RFS rates and OS rate are 63.3% and 67.3%;TS group and SOX group for 1 years RFS rates were 83.3% and 88.7%(P=0.269),OS rates were 91.7% and 98.1%(P=0.228),2 year RFS rates were 68.8% and 71.1%(P=0.859),2 year OS rates were 62.5% and 82.2%(P=0.107),3 year RFS rates were 41.7% and 74.3%(P=0.074),3 year OS rates were 41.7% and 75.7%,(P=0.029);2.The median RFS in the TS group and SOX group were 38.0 months and58.3 months t(P=0.027),and the median OS were 41.1 months and 62.3 months(P=0.057).The patient's gender may be an independent prognostic factor,P =0.019.The different N stage is the effective factor of OS(P=0.020);3.Stratified analysis of two groups of 1 years RFS and OS,in patients with positive cancer nodules and nerve invasion positive,TS showed higher rate than that of the SOX programme of the 1 year RFS rate: 100% VS 62.5%(P=0.491),80% VS 75%(P=1.000),1 year OS rate: 100% VS 87.5%(P=1.000),100% VS(87.5% P=0.152).There was no statistical difference between the two groups.Analysis of influencing factors of TS and SOX in gastric cancer patients undergoing adjuvant chemotherapy for 1 years RFS and OS after operation,gender had influence on 1 years of RFS(P=0.016),sex and tumor size on 1 years OS(P=0.016,P=0.033).The other influence of other factors were statistically significant;5.TS group and SOX group's recurrence and metastasis rate show that: peritoneal metastasis(0% VS 1.9%),pelvic metastasis(12.5% VS 3.8%),peritoneal metastasis(20.8% VS 13.2%),liver metastasis(0% VS 7.5%),anastomotic recurrence(0% VS 1.9%),bone metastasis(4.2% VS 0%),brain metastasis(4.2% VS 0%),retroperitoneal lymph node metastasis(12.5% VS 3.8%),there was significant difference between two groups(P=0.010);5.TS group and SOX group myelosuppression and peripheral neurotoxicity incidence rate were: 91.3% VS 73.4%(P=0.188)and 25% VS(15.9% P=0.385),TS group of neutrophils decreased more than SOX group,SOX group and chemotherapy thrombocytopenia than TS group,the difference was statistically significant,white blood cell,hemoglobin decrease,reduce fatigue,nausea and vomiting,loss of appetite,liver damage,diarrhea in two groups showed no significant difference(P>0.05).The whole TS group used TCM,96.2% of the SOX group used.Conclusion: 1.TS program is one of the effective methods of adjuvant chemotherapy after radical resection of gastric cancer,the short-term effect is equivalent to SOX;TS shows benefit on patients with high risk factors such as cancer nodules and nerve invasion,;and TS maybe reduce the incidence of liver metastasis.2.Gender is independent factor of RFS after gastric cancer surgery,postoperative N staging is the independent factor of OS;gender and tumor size is influencing factors of 1 year's OS.3.The incidence of bone marrow suppression and peripheral neurotoxicity were slightly higher than that of SOX in TS regimen,but no significant difference.After TS chemotherapy,neutrophils decreased more than SOX,and platelets decreased by more than TS after chemotherapy with SOX regimen;Whether the use of Chinese herbal medicine should be strengthened during the use of TS should be further studied. |
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