Analysis Of Efficacy And Prognostic Factors Of Neoadjuvant Chemotherapy For SOX Regimen In Stage ?B-?C Gastric Cancer

Objective: To investigate the clinical efficacy and prognostic factors of patients with stage ?B-?C gastric cancer treated with S-1 capsule combined with oxaliplatin injection(SOX regimen).Methods: This study collected data of 85 patients with gastric cancer from stage ?B-?C who underwent gastrointestinal surgery from the Affiliated Hospital of North Sichuan Medical College from May 2015 to February 2017.Among them,41 patients(experimental group)underwent SOX regimen with neoadjuvant chemotherapy.After 2 cycles of chemotherapy,evaluate the efficacy.If the condition is stable or effective,continue the third cycle of chemotherapy.After 3-4 weeks of the last chemotherapy,D2 radical surgery is performed.If the disease progresses,ask the patient and the family to agree,stop the neoadjuvant chemotherapy to the surgical treatment,and the patient undergoes the original chemotherapy after the operation.Forty-four patients(control group)underwent D2 radical surgery immediately after admission,and the postoperative treatment was the same as the experimental group.The R0 resection rate,the average operation time,the mean intraoperative blood loss and the average hospitalization time,postoperative complications and prognosis were compared between the two groups.At the same time,different factors after neoadjuvant chemotherapy in the experimental group(different curative effect after tumor neoadjuvant chemotherapy,Whether there are N-down,different tumor marker values)prognostic differences were compared and statistical analysis.Result:(1)The R0 resection rate was 97.6% in the experimental group and 81.8% in the control group.The difference was statistically significant(P<0.05);(2)the average operation time of the experimental group(3.12±0.30hVS3.07±0.28 h,P>0.05),averaging The median bleeding volume(129.33±26.65mlVS117.20±39.95 ml,P>0.05)and mean hospitalization time(11.33±2.01daysVS10.91±2.71 days,P>0.05)were not statistically significant compared with the control group;(3)There were no significant differences in pulmonary infection,peritoneal effusion,abdominal infection,intraperitoneal hemorrhage,anastomotic fistula,duodenal stump fistula,lymphatic leakage,intestinal obstruction,poor wound healing,gastric emptying disorder and postoperative mortality between the two groups(P > 0.05).(4)The median survival time of patients in the experimental group was significantly different from that in the control group(30monthsVS20months,P <0.05).(5)The median survival time of patients with objective remission after neoadjuvant chemotherapy in the group was longer than that of the ineffective patients(37monthsVS23months),the difference was statistically significant(P<0.05);(6)There was a statistically significant difference in the median survival between N-downgrade patients and N-stage unchanged or increased patients with neoadjuvant chemotherapy in the experimental group(36monthsVS26months,P<0.05).(7)The mean survival time of patients with CEA ? 5.00 ?g/L after neoadjuvant chemotherapy in the experimental group was not significantly different from that of patients with CEA>5.00 ?g/L(31.8monthsVS28.0months,P>0.05).Neoadjuvant chemotherapy The median survival time of patients with CA19-9?37.00U/ml was statistically significant compared with CA19-9>37.00U/ml(37monthsVS23months,P<0.05).Conclusion: Neoadjuvant chemotherapy with SOX regimen in patients with stage ?B-?C gastric cancer does not increase the average length of surgery,hospital stay,and mean intraoperative blood loss,and does not increase postoperative complications and postoperative mortality;SOX regimen neoadjuvant chemotherapy improved surgical R0 resection rate and postoperative Long-term survival rate with stage ?B-?C gastric cancer;the prognosis of patients with objective response after neoadjuvant chemotherapy in the experimental group is better than that of the ineffective patients.The prognosis of patients with N-down is better than that of patients with N-stage unchanged or increased.Patients with normal CA19-9 measurements were better than patients with increased CA19-9 measurements.