The Clinical Efficacy And Pathological Evaluation Of Triplet Combinations Regime And Doublet Combinations Regime In The Neoadjuvant Chemotherapy For Advancedgastric Carcinoma

Observation:We assessed the effectiveness and tumor retraction of DOS/DOX/EOS/EOX(docetaxel or epipirubicin,,oxaliplatin and S-1 or capecitabine)compared with XELOX(oxaliplatin and S-1 or capecitabine)as preoperative chemotherapy for locally advanced gastric cancer.Methods: 143 patients with advanced gastric cancer treated in Cancer Hospital affiliated to Xinjiang Medical University from February 1,2014 to February 1,2016 were analyzed retrospectively.The curative effect of chemotherapy,related adverse reactions and tumor degradation were observed and recorded in the two groups.the resection rate,radical resection rate,pathological regression rate and disease-free survival time of the two groups were compared.the relationship between different regimens and the degree of tumor regression was analyzed.Results: 53 of 143 patients were treated with three-drug regimen chemotherapy,90 cases received two-drug regimen chemotherapy,the objective remission rates of the three-drug regimen group and the two-drug regimen group were 52.8% and31.1%(P=0.017),and the disease control rates were 94.3% and 81.1%(P=0.051),respectively.The complete pathological regression rates of the three-drug regimen group and the two-drug regimen group were 3.3% and 6.9%,respectively.The pathological significant regression rates were 63.3% and 25.1%,respectively(P=0.006).The resection rates of R0 were 54.7% and 28.9% respectively(P=0.021).The median DFS of the three-drug regimen group and the two-drug regimen group were 29 months and 26 months,respectively(P=0.800),.the DFS of the significant tumor regression group was30.5 months,and 25 months in non-significant tumor regression group(P=0.001).The median DFS of TRG0/1 combined with three-drug regimen were 28 months,and TRG2/3combined with three-drug regimen were 21 months,TRG0/1 combined with double-drugregimen were 44 months and 25 months for TRG2/3 combined with double-drug regimen.(P=0.01).The most common side effects of three drugs and two drugs in grade III and above III were leukopenia,neutropenia and thrombocytopenia: 26.4% and 8.9%(P=0.010),32.1% and 11.1%(P=0.004),28.3% and 6.7%(P=0.001),respectively.Conclusion: compared with the two drug groups,the patients with better objective remission rate,tumor regression rate,surgical resection rate,R0 resection rate after neoadjuvant treatment performed in the triplet combinations group,the side effects of the doublet combinations group were less and the patients were well tolerated,there was no significant difference in DFS between the two groups,Patients with significant tumor regression had better DFS.