Retrospective Analysis Of Oxaliplatin Combined With S-1(SOX) As Second-line Treatment For Advanced Gastric Cancer

Objective:There is no standard second-line treatment in advanced gastric cancer,our study retrospectively analyzed the efficiency and safety of Oxaliplatin combined with S-1(SOX)as second-line treatment in advanced gastric cancer patients who failed paclitaxel combined with fluorouracil treatment,as well as analysis the factor in patients with advanced gastric cancer.Methods:Collect patients from January 1,2010 to December 31,2015 in the First Affiliated Hospital of Nanchang University,who confirmed gastric cancer by pathology.Screen out stage IV?received paclitaxel and fluorouracil(not including s-1)chemotherapy in the past ? received SOX regimen as second-line treatment.Collect and sort out their clinical data,including: the baseline clinical characteristics,clinical efficacy and adverse reactions,analysis OS?PFS?RR and DCR.Statistical analysis was performed by SPSS20.0,using Kaplan-Meier method analyzed long-term efficacy and single prognostic factors analysis,using COX proportional hazards modelthe to analyze the meaningful factors for multivariate analysis and looking for the independent prognostic factor.Results:A total of 72 patients with advanced gastric cancer were enrolled in this study.Included,44 male patients(61.1%),28 female patients(38.9%);the median age was 60.5 years(44-71 years);the median number of treatment cycles in SOX was 6(2-9)cycles;27 patients had a performance status(ECOG)0 score,45 patients had a performance status(ECOG)1 score;a total of 29 cases(40.3%)PFS of the first-line treatment ?6 months and 43 cases(59.7%)>6 months;before second treatment,there are 42 cases(58.3%)of anemia patients,30 cases(41.7%)of non anemia patients;18.1% of patients received palliative surgery;30.6% patients who received three or more treatment.Results show,RR is 26.4%,DCR is 65.3%,mPFS was 4.5 months;mOS was 8.6 months,the 1 year survival rate was 30.6%.The main adverse reactions were myelosuppression and peripheral neurotoxicity,neutropenia incidence rate was 84.7%,the 3-4 incidence rate was 23.6%;the incidence of anemia was 81.9%,the 3-4 incidence rate was 6.9%;the incidence rate of thrombocytopenia was 47.2%,the 3-4 incidence rate was 5.6%;the incidence of peripheral neurotoxicity was 80.6%,the incidence rate was 3-4 6.9%.Single factor analysis showed that Lauren 's classification,ECOG score,anemia before second-line treatment,first-line treatment of PFS,three-line treatment affect survival in patients with advanced gastric cancer;multivariate analysis showed that ECOG score,anemia before second-line treatment,first-line treatment of PFS was an independent prognostic factor in patients with advanced gastric cancer.Conclusion:For patients with gastric cancer treated by the combination of paclitaxel and fluorouracil,the SOX regimen as second-line therapy has good curative effect,and the adverse reaction is well tolerated.ECOG score,anemia status before treatment,and first-line treatment of PFS were independent prognostic factors for survival in such patients.