Efficacy And Safety Of Maintenance Therapy With Capecitabine Or S-1 After First-line Chemotherapy With Stage ? Gastric Cancer With DOX Or DOS

Purpose:Patients with stage ? gastric cancer who have undergone first-line chemotherapy with DOX or DOS regimen are generally followed up for observation and follow-up until the disease progresses,and second-line chemotherapy is given.Based on the efficacy of maintenance therapy in other advanced solid tumors such as colon cancer,this study retrospectively collected patients with stage ? gastric cancer who received capecitabine or S-1 maintenance therapy after first-line chemotherapy with DOX or DOS regimen,and analyzed and discussed the efficacy and safety of maintenance therapy after first-line chemotherapy for gastric cancer.Methods:This study included 40 patients with stage ? gastric cancer who had received first-line chemotherapy with DOX(Docetaxel+Oxaliplatin+Capecitabine)regimen or DOS(Docetaxel+Oxaliplatin+S-1)regimen from September 2016 to February2018 in our hospital.Forty patients were divided into maintenance group and control group according to whether they continued to receive capecitabine or S-1maintenance chemotherapy after the completion of first-line chemothe-rapy.Maint-enance group:no disease progression was observed after chemotherapy with DOX or DOS first-line regimen,followed by capecitabine 1000mg/m~2,oral,2 times/d,d1~d14,21 d for 1 cycle or Tiggio 1)Surface area(S)?1.25 m~2,40 mg/time;2)S=1.25~1.5 m~2,50 mg/time;3)S?1.5 m~2,60 mg/time,oral,2 times/d,d1~d14,21 days as one cycle of regimen to maintain chemotherapy.Control group:chemoth-erapy was not continued after first-line chemotherapy,and patients were admitted to the hospital on a regular basis and received the best supportive care.Study objectives:objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS),overall survival(OS)and adverse events(AE).The patient's clinical data were carefully sorted and retrospecti-vely analyzed.All data were statistically analyzed using SPSS 21.0.If P<0.05,the difference was statistically significant.Results:(1)There was no significant difference in clinical baseline characteristics between the two groups.The ORR of the maintenance group was 35.0%,the DCR was 70.0%,the ORR of the control group was 10.0%,and the DCR was 40.0%.Compared with the control group,the ORR,DCR in the maintenance group was significantly higher than that in the control group,but the P values were all greater than 0.05,and the difference was not statistically significant.(2)The median PFS of the maintenance group was 8.81 months(95%CI 5.48 to12.14 months),and the control group was 6.10 months(95%CI 5.35 to 6.85 months).The median PFS of the maintenance group was longer than that of the control group,and the difference was statistically significant(P<0.0001).(3)The median OS of the maintenance group was 12.85 months(95%CI was12.43 to 13.27 months),and the control group was 11.34 months(95%CI was 10.28to 12.40 months)(P=0.001).(4)Adverse reactions in the maintenance group were mainly myelosuppression,gastrointestinal reactions,hand-foot syndrome and oral mucositis.Most of the toxic side effects ranged between grades I and II,with no grade ? adverse reactions and chemotherapy-related deaths.Conclusions:Patients with stage ? gastric cancer received DOX or DOS first-line chemotherapy follow-up capecitabine or tigio maintenance therapy,the disease-free progression-free survival time and overall survival time were improved compared with the best support therapy,although the objective remission rate,disease control rate has increased,but there is no statistically significant difference.