The Study Of SOX As An Adjuvant Chemotherapy In Adenocarcinoma Of Esophagogastric Junction

Objective:Gastric carcinoma and carcinoma of the esophagogastric junction(CEG)is a highly invasive malignant tumor in the digestive system,is the third most common cause of cancer-related death in the world.The incidence rate of gastric cancer showed a downward trend,but the incidence of CEG rose steadily.From the pathological point,CEG consists of esophageal squamous cell carcinoma and adenocarcinoma of the esophagogastric junction(AEG),there are nearly 50% patients in the initial diagnosis of locally advanced,and have a poor prognosis,although patients after R0 radical resection,the 5 year survival rate is below 20%.Some adjuvant and neoadjuvant therapy of gastric cancer has shown that compared to the single surgical treatment improves about 15% survival.There are still a lot of controversy about treatment options of the AEG.This paper retrospectively analyzed the relevant research of postoperative adjuvant chemotherapy in patient with AEG,to evaluate the efficacy and safety of SOX and PF regimen,and to explore more suitable chemotherapy regimen for patients with AEG.Methods:The clinical information of 76 patients with AEG who had accepted radical operation and pathological staging was three period,was collected from October 2010 to October 2013 of PLA 105 th hospital,38 patients received S-1 plus oxalipatin(SOX)regimen,38 patients received 5-Fu plus cisplatin(PF)regimen.Compared disease-free survival(DFS),overall survival(OS)and the adverse reactions of the two groups.Kaplan-Meier method and Log-rank test were used for survival analysis,the chi square test was used for comparing the rate,adverse reactions were classified according to the National Cancer Institute Common Toxicity Criteria version 3.0(NCI-CTC V3.0).Results: 1.In SOX group,the median DFS was 33.2 months,higher than 17.8 months in the PF group,the difference was statistically significant(?~2=18.918,P<0.001).2.In SOX group,the median OS was 39.3 months,higher than 23.4 months in the PF group,the difference was statistically significant(?~2=24.789,P<0.001).3.In SOX group and PF group,the main side effects were myelosuppression and gastrointestinal reactions,such as leukopenia and neutropenia,anemia,nausea,vomiting,grade?~?as the main.In SOX group and PF group,the incidence of leukocyte reduction were 44.7% and65.8%,respectively.The incidence of anemia were 36.8%,55.3%,the incidence of thrombocytopenia,respectively 7.9%,10.5%,liver injury incidence rate were 15.8%,18.4%,renal injury incidence rate were 7.9%,15.8%,there were no statistically significant differences(P>0.05).The incidence of neutropenia in the two groups were39.5% and 65.8%,with significant difference(?~2=5.278,P=0.022);the incidence of nausea and vomiting in the two groups were 42.1%,65.8%,there was significant differences(?~2=4.290,P=0.038).Peripheral nervous system toxicity incidence of the SOX group was higher than PF group.The difference was statistically significant(?~2=10.050,P=0.002),but the toxicities were tolerable.Conclusion:The SOX regimen as the postoperative adjuvant chemotherapy of AEG,compared with PF,can prolong the median DFS and OS,toxicity can be tolerated,and has obvious advantages.It provides a basis for further large samples of clinical trials.