Clinical Observation Of Apatinib Combined With Oxaliplatin And Teggio For Postoperative Adjuvant Treatment Of Stage ? Gastric Cancer

Background and Objective: Gastric cancer is a common malignant tumor of the digestive tract.The incidence rate is the fifth highest and the mortality rate is the second in the world.The rate of early diagnosis of gastric cancer is low in China.About two-thirds of patients have been in advanced stages.Currently,it is a comprehensive treatment based on surgery.Local recurrence and distant metastasis are important factors affecting the survival of patients.Therefore,adjuvant therapy has become the key to improve the cure rate and prolong the survival of patients.The purpose of this real world study is to investigate the efficacy and safety of apatinib plus oxaliplatin and teggio for postoperative adjuvant treatment of stage ? gastric cancer.Methods: In this study,38 patients who underwent concurrent adjuvant therapy for radical gastrectomy for gastric cancer were selected at the Qingdao muncipal hospital in2015.1-2017.1.The trial was divided into two groups.The control group was treated with oxaliplatin and teggio(n=20),observation group: oxaliplatin,teggio and apatinib(n=18),no less than 2 cycles of adjuvant chemotherapy and no less than 3 months for apatinib.The patients were regularly reviewed after surgery.All cases were followed up through the medical record query system,outpatient or telephone,and were followed up to February 1,2018.The disease free survival rate(DFS rate),overall survival rate(OS rate),influencing factors,and adverse reactions of the two treatment options were compared.SPSS 22.0 was used for data analysis.P<0.05 was considered statistically significant.Results: The follow-up time of 38 patients was 13-34 months and the median follow-up time was 27 months.The observation group received an average of 4.9 cycles of chemotherapy while the control group received an average of 6.5 cycles of chemotherapy.Six patients had grade 3-4 leukopenia,four patients had grade 3-4 hypodynamia,and three patients had grade 3-4 thrombocytopenia.all patients had no death caused by adverse drug reactions through symptomatic treatment or temporary withdrawal or continued administration of apatinib from 500 mg per day to 250 mg per day.1.A total of 38 patients with complete follow-up data were included in the study.The patient's one-year DFS rate and OS rate were 81.6% and 94.7%,and the two-year DFS rate and OS rate were 53.6% and 81.6%,respectively.The one-year DFS rates for the observation and control groups were 88.9% vs 75.0%(P=0.41),the one-year OS rate was 100.0% vs 90.0%(P=0.488),and the two-year DFS rate was 83.3% vs 55.5%(P=0.031).The two-year OS rate was 88.9% vs 83.3%(P=0.410),respectively.Overall,the two-year DFS rate in the observation group was better than that in the control group.The difference was statistically significant.2.The DFS rate and OS rate of one year in observation group and control group were analyzed,the results show that the DFS rate and OS rate of one year in two groups had no statistical significance in the related clinicopathological factors such as sex,age,tumor site,tumor size,tumor stage,ECOG score,chemotherapy cycle,tumor pathological classification,T and N stage,vascular tumor thrombus and nerve invasion.3.Adverse reactions: Adverse reactions of the two groups are neutropenia(83.3%vs70.0%),thrombocytopenia(66.7%vs50.0%),anemia(66.7%vs60.0%),oral ulcer(38.9%vs25.0%),hand and foot syndrome(16.7%vs10.0%),hypertention(44.4%vs10.0%),proteinuria(22.2%vs5.0%),neurotoxicity(16.7%vs20.0%),but most of them belonged to 1-2 grade and were tolerable.The incidence of hypertension in the observation and control groups was 44.4% vs 10.0%(P=0.031),respectively,and the difference was statistically significant.Conclusions: 1.Apatinib combined with oxaliplatin and teggio may prolong two-year disease-free survival rate for postoperative adjuvant treatment of stage III gastric cancer.2.For patients with stage III gastric cancer,compared with chemotherapy alone,there was no statistically significant difference in the incidence of neutropenia,thrombocytopenia,oral ulcers,hand-foot syndrome,proteinuria and neurotoxic adverse reactions in apatinib plus chemotherapy.However,there was a statistically significant difference in the incidence of hypertension between the two groups,and it is necessary to expand the sample to study further.