Compared Efficacy Between Paclitaxel Liposome Combined With Modified FOLFOX6 And S-1 Regimen For Recurrent Patients With Postoperative Gastric Cancer

Objective: To compare clinical effects of Paclitaxel liposome combined with modified FOLFOX6 regimen with S-1 and analyze prognostic factors for recurrent patients with postoperative gastric cancer.Methods: A retrospective analysis of 95 recurrent patients undergoing the radical resection of gastric cancer at General Surgery Department of Lanzhou University Second Hospital was conducted from January 1,2013 to June 1,2016.According to different chemotherapy regimens,all patients were divided into two groups,of which 45 patients were treated with S-1 regimen and50 patients with paclitaxel liposome combined with modified FOLFOX6 regimen.Clinical datas including age,gender,TNM staging,surgical procedures,postoperative recurrence time,histopathological types,metastatic recurrence sites,chemotherapy cycles,KPS scores,and tumor markers were collected.After 4 treatment regimens with intervals of 21 days,clinical effects of the two groups were evaluated.These datas were analyzed by SPSS 17.0.The categorical variables were conducted using the Chi-square test and the correlation between chemotherapy time and overall survival was analyzed by Pearson correlation test.Prognostic factors were analyzed with COX proportional hazards regression model by Kaplan-Meier method.The statistical differences were significant at P<0.05.Results:1.Of the 45 patients treated with the S-1 regimen,0 had complete remission(CR),13 had partial remission(PR),18 had stable disease(SD),and 14 had progressive disease(PD).The overall response rate(ORR,CR+PR)was 28.9%,and the clinical benefit rate(CBR,CR+PR+SD)was 68.9%.Of the 50 patients treated with the paclitaxel liposomes combined with modified FOLFOX6 regimen,0 had CR,16 had PR,23 had SD,and 11 had PD.The ORR was 32.0%,and the CBR was 78.0%.There were no significant statistical differences in the remission rate and clinical benefit rate(P>0.05).2.The median overall survival time was 8.3 months in the group with the S-1 regimen and it was 9.1 months in the other group with the paclitaxel liposomes combined with modifiedFOLFOX6 regimen.Compared with the group with the S-1 regimen,the median overall survival time was significantly longer in the group with the paclitaxel liposomes combined with modified FOLFOX6 regimen.The statistical differences were significant between the two groups in the median overall survival time(P<0.05).3.The univariate analysis revealed that TNM staging,histopathological types,KPS scores before treatment,CEA levels,and CA199 levels were correlated with the overall survival time(P<0.05).While,The age,gender,surgical procedures,postoperative recurrence,metastatic sites,and chemotherapy cycles weren't related(P> 0.05).TNM staging,KPS scores before treatment,CEA levels,and CA199 levels were main factors in prognosis by COX regression multivariate analysis.4.During the treatment,the obvious toxicities included myelosuppression,gastrointestinal discomfort,hepatic and renal injure,and allergies between the two groups.There were no significant differences in incidence of toxicities(P>0.05).Conclusion:1.In the short-term treatment,both the two groups were effective.Further study revealed the group with Paclitaxel liposome combined with modified FOLFOX6 regimen was superior to the group with the S-1 regimen in the median overall survival time.2.TNM staging,KPS scores before treatment,CEA levels,and CA199 levels were probably main factors in prognosis for recurrent patients with postoperative gastric cancer.3.In addition,the study showed common toxicities during the treatment between the two groups were mainly grade I and II toxicities including myelosuppression,gastrointestinal discomfort,hepatic and renal injure,and allergies,which were tolerated.