| BACKGROUND:Carcinoma of stomach is one of the most common malignancies in digestive system.It has a high incidence and mortality,accounting for the second place in cancer-related deaths[1].Many patients with gastric cancer are at advanced stages of diagnosis and have lost the chances of radical surgery.The chances are that patients with advanced gastric cancer have a poor prognosis and a short survival period,which greatly affected the patient's quality of life.The main treatment for advanced gastric cancer is chemotherapy,aiming at prolonging the survival time and improving the quality of patient's life.Because advanced gastric cancer is often combined with other site metastases,and the patient's sensitivity to conventional chemotherapy is poor,it is difficult for clinicians to choose chemotherapy regimens.At present,the standard chemotherapy for advanced gastric cancer is still debatable.In the past,chemotherapy regimens with 5-FU and cisplatin were mostly used.Because of their bone marrow suppression and severe gastrointestinal reactions,patients are more difficult to tolerate.It has been reported that oral fluoropyrimidines are used as alternatives.S-1and capecitabine have better efficacy,lower adverse reactions,and are currently recommended for the treatment of advanced gastric cancer.Oxaliplatin is the third generation of platinum-based chemotherapeutic drugs,and has an inhibitory effect on tumors and fluoride.Pyrimidines have better synergistic effects than cisplatin,and have a low incidence of adverse reactions and no cross-resistance with other platinum groups.They are also recommended for advanced gastric cancer,but about capecitabine combined with oxaliplatin and tega There is no definitive conclusion on the combination of oxaliplatin in advanced gastric cancer chemotherapy.OBJECTIVE:To retrospectively analysis of the efficacy and safety of capecitabine combined with oxaliplatin and oxaliplatin in the clinical treatment of patients with advanced gastric cancer and analysis of the possible factors of their differences,to provide further evidence support and treatment for the establishment of clinical treatment of advanced gastric cancer.Methods:According to different chemotherapy regimens,sixty inoperable advanced gastric cancer patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to March 2017 were randomly divided into two groups.30 patients in the combination of S-1 and oxaliplatin?SOX?group were given a cycle of 21 days and 80 mg/m2 capsule was taken orally twice a day for 14days.Thirty patients in the capecitabine plus oxaliplatin group?XELOX?group,21days for 1 cycle,capecitabine 1200 mg/m2,orally,twice a day for 14 days,oxaliplatin was used in the same manner.SOX group.Both groups of patients were routinely treated with tropisetron antiemetic before treatment.All patients were evaluated according to RECIST 1.1 and CTCAE 4.0 evaluation criteria after 2courses of treatment.SPSS 19.0 was used to count the results of the two groups.Learn to analyze.Results:1.Short-term efficacy:Objective effective rate?ORR?was 56.6%in the oxaliplatin group?SOX group?,and the disease control rate?DCR?was 80.0%;ORR was 33.3%in the XELOX group,and DCR was 56.6.%,suggesting that the clinical efficacy of the SOX group may be better than the XELOX group,but there is no statistical difference in ORR and DCR between the two groups?P=O.894 and P=0.800?.2.Long-term efficacy:Patients in the SOX group had an average PFS of5.997 months,a median PFS of 5.6 months,an average OS of 16.283 months,a median OS of 17.0 months,and an average PFS of 5.740 months in the XELOX group.The median PFS was 5.5 months,the average OS was 16.457 months,and the median OS was 16.5 months.There was no statistical difference between the two groups in PFS and OS?P=0.356 and P=0.699?.3.Adverse reactions:Both groups of patients reported adverse events,but no serious adverse reactions led to the termination of treatment and adverse outcomes.The incidence of hand-foot syndrome was significantly higher in the XELOX group than in the SOX group?P=0.013?.The incidence of other adverse reactions was similar,with no statistically significant difference?P>0.05?.For grade 3-4 adverse reactions,the incidence of SOX was higher in the XELOX group and the incidence was 33.3%and 36.7%,respectively.In the SOX group,vomiting and leukocytopenia were the more common Grade 3-4adverse events.In the XELOX group,vomiting and constipation were the more common Grade 3-4 adverse events.4.Influencing factors of recent curative effect:histological type?P=O.010?is an independent influencing factor of the efficacy of schizophrenia combined with oxaliplatin chemotherapy,and lymph node metastasis?P=0.037?is capecitabine combined with Oza Independent factors affecting the efficacy of the Liboplatin regimen.5.The histological type,pathological stage,whether there is lymph node or liver metastasis are independent factors affecting the prognosis of patients with advanced gastric cancer.Lymph node metastasis and hepatic metastasis were independent risk factors for advanced gastric cancer prognosis?B>0?.Histological type and pathological stage were independent protective factors for the prognosis of gastric cancer?B<O?,ie,the degree of histological differentiation was higher and pathological stage was higher.The earlier patients had a better prognosis,and other factors such as the occlusive regimen,gender,age,and tumor site were not statistically significant with advanced gastric cancer?P>O.05?.conclusion:1.The short-term and long-term efficacy of the combination of S-1 and oxaliplatin in patients with advanced gastric cancer is comparable to that of capecitabine and oxaliplatin,but the cost of treatment is slightly higher.2.The incidence of hand-foot syndrome was higher in the XELOX group than in the SOX group.The safety of the two chemotherapy regimensThere is no detail difference between tolerance and tolerance.3.The histological type is an independent factor affecting the short-term efficacy of the chemotherapy regimen of S-1 and oxaliplatin,while lymph node metastasis is an independent factor affecting the short-term efficacy of capecitabine and oxaliplatin regimens,but the two regimens independently affect Factors need to be further confirmed by increasing the sample size.4.The histological type,pathological stage,whether there is lymph node or liver metastasis are independent influencing factors for the long-term survival of patients with advanced gastric cancer.Lymph node metastasis and liver metastasis are independent risk factors for the prognosis of advanced gastric cancer.Histological type and pathological stage are independent protective factors for the prognosis of gastric cancer.Patients with higher histological differentiation and earlier pathological stages have better prognosis. |
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