| Background and objective: gastric cancer is the fifth most common malignant tumors,gastric cancer treatment usually lymph node dissection,enlarged lymph node excision,usually defined as D2 of gastric cancer resection,although the surgical technology matures,the national cancer database,10 year survival rate of gastric cancer is only 65%[1],so high the local recurrence rate and distant metastasis rate of the gastric cancer treatment difficulties in recent years,[2],platinum,fluorouracil analogues,paclitaxel is widely used in clinic,S-1 belongs to the three generation of 5-fluorouracil derivatives,by tegafur,gimeracil(FT)(CDPH),O Tirasi(OXO)in accordance with the composition with a certain proportion of the preparation,in recent years,Japanese researchers continue to study the role of adjuvant chemotherapy for gastric cancer,2007 ACTS-GC[1] experimental gastric cancer S-1 adjuvant chemotherapy group published his The landmark phase III trial supports the use of S-1,but the trial did not directly compare the adjuvant chemotherapy regimen.Therefore,the two kinds of S-1 adjuvant treatment in common S-1 monotherapy and combined with oxaliplatin scheme comparison highlights the significance.Treatment methods: Sox scheme: Asha Leigh Per treated with S-1 combined with chemotherapy,the dosage: Asha Leigh Per 130mg/m2,Asha Leigh Per(Jiangsu Lianyungang Hengrui pharmaceutical Limited by Share Ltd,130 mg/m2),using the method of intravenous infusion for first days,120 min infusion,every 21 days for a cycle,a new era of S-1 capsule(Shandong Pharmaceutical Company Limited production the surface area of less than 1.25 square meters,each 40 mg,the surface area of more than 1.25 square meters of less than 1.5 square meters per 50 mg,the surface area of more than 1.5 square meters per 60mg).S-1 group: oral S-1(a new era of Shandong Pharmaceutical Company Limited production,the surface area of less than 1.25 square meters per 40 mg oral,body surface area more than 1.25 square meters of less than 1.5 square meters per 50 mg oral,body surface area more than 1.5 square meters per oral 60mg).Half an hour before the intravenous chemotherapy with routine antiemetic tropisetron and dexamethasone treatment,oral chemotherapy donot related to treatment,chemotherapy after III-IV myelosuppression treated with granulocyte colony-stimulating factor support treatment,once difficult to tolerate chemotherapy related adverse reactions,immediately terminate the experiment.In the course of treatment were given the same antiemetic,anti allergy,liver and other auxiliary medicine.Results: 70 cases of patients with a total of 489 cycles of chemotherapy,the average completed 6.88 cycles of chemotherapy,S-1 combined with oxaliplatin group a total of 117 patients completed 584 cycles of chemotherapy,the average completed 4.94 cycles of chemotherapy.1 SOX group compared with the S-1 group in the disease free survival rate was 62.70% and 55.76%,P value was 0.66,P value was greater than 0.05,no statistical difference.In the 5 year overall survival rate of the SOX group was and the value of was higher than that of the S-1 group,and the p value was 57.41% VS 55.28% and,and the difference was not statistically significant(P).2 two groups of patients were stratified for age,tumor location,tumor size,Laurence type,duration of chemotherapy,2 references will be according to age greater than 65 and less than or equal to 65,divided into two layers according to the anatomical location of the tumor into the gastric fundus,gastric body,antrum is divided into 3 layer,the maximum diameter of tumor by less than 5cm and greater than or equal to 5cm is divided into two layers,according to Laurence of diffuse type and intestinal type is divided into two layers,according to the time of chemotherapy is greater than 6 and less than or equal to 6 cycle period is divided into two layers,through statistical analysis,the results showed that in tumor stage of III patients,SOX for five years RFS than in the S-1 group,61.8%VS 41.5%,P value was 0.039,with statistical significance,in the five year overall survival rate of SOX group compared with S-1 group was 64.7% VS 46.3%,P value was 0.06.The survival curves are shown in Table 5 significant edge.The overall survival rate of the SOX contrast S-1 scheme was 96.6% P in the patients with stage I-II,with a significant margin of 81.9%VS of 0.057.3 factors affecting the RFS and the OS of the 5 year old patients with adjuvant chemotherapy in the past 5 years It was found that RFS and OS 5 year period more than 6 cycles of chemotherapy were significantly higher than the 6 period following patients were stratified subgroup according to the chemotherapy cycle length(up to June,or June),(July or July,<>(<>)in August or August),(September or September,<>)respectively.Comparison of subgroups of different period RFS and OS survival curves.You can clearly see,the chemotherapy cycle for 6 months when the visible RFS were 42.25 VS 50.68,P = 0.039,P value is less than 0.05,there was significant difference between the survival curves as shown in Figure 9,but in 7,8,9 months when the P values were 0.149,0.591,0.985,were there was no statistical difference,RFS did not show a prolonged,suggesting that the chemotherapy cycle more than 9 months after the extension does not bring a significant survival benefit.It is suggested that adjuvant chemotherapy for gastric cancer is 6-8 cycle.4 adverse reactions of the two groups of patients were analyzed and found S-1 group during neutropenia,reduce the total number of leukocytes and peripheral neurotoxicity of these 3 aspects show advantages,S-1 single drug group were neutrophils of 21 different degrees of reduction,while Sox group 44 showed the number of neutrophils reduced P value equal to 0.09,there was significant difference.A total of 20 patients in the S-1 monotherapy group decreased the number of white blood cells in different degrees,while in the Sox group,the total number of white blood cells decreased in all the 55 groups,and the p value was equal to 0.012.S-1 group only 1 people had peripheral neurotoxicity,while Sox group 17 showed peripheral neurotoxicity,the p value is equal to 0.033 for chemotherapy related adverse reactions induced by oxaliplatin.conclusion(1): S-1 plus oxaliplatin versus S-1 monotherapy for the adjuvant treatment of gastric cancer 5 years disease-free survival and overall survival showed no significant difference between the five years.(2): SOX scheme has advantages in postoperative adjuvant chemotherapy for patients with III gastric cancer.(3): 6-8 cycle chemotherapy time can significantly improve the disease-free survival of patients with 5 years,long chemotherapy time and no survival benefit. |
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