Efficacy Comparison And Safety Analysis Between DCX Regimen And DP Regimen For Clinical Use In Advanced Gastric Cancer

Objective:The study was to evaluate and compare the efficacy and safety of DCX regimen(docetaxel,cisplatin,capecitabine)and DP regimen(docetaxel,cisplatin)in the treatment of advanced gastric cancer in a retrospective way,and also analyzed the possible factors that may affect the overall survival time of patients who suffered from advanced gastric cancer.Methods:The retrospective study of 122 patients with advanced gastric cancer admitted to our hospital from February 2016 to February 2018 was divided into study group(n=60)and control group(n=62)according to different chemotherapy regimens.The control group was treated with DP regimen,and the study group was given capecitabine on the basis of the control group.Compared the progression-free survival time,overall survival time,objective response rate,disease control rate,one-year survival rate,and incidence of toxicity between the two groups,and analyzed the possible prognostic factors as well.The changes of intestinal mucosal barrier function and tumor markers were compared after each treatment.Results:A total of 122 patients were enrolled in the study,in which 60 patients used DCX regimen and 62 patients used DP.The median PFS of the study group and the control group were 5.26 months(95%CI:4.59-5.93 months)and 4.49 months(95%CI:3.81-5.18 months),with no significant difference(P=0.298).The median OS were 12.08 months(95%CI:10.92-13.25 months)and 9.88 months(95%CI:8.72-11.04 months)(P=0.0292).The objective response rate for the two groups were 56.67%and 40.32%,respectively,with no statistical significance(P=0.071).The disease control rates were 80.00%and 62.90%(P=0.037).The one-year survival rates of the two groups were 41.67%versus 24.19%.After treatment,the serum DAO,LPS and L/M levels increased in the two groups,and the control group increased significantly.The expression of CA19-9 decreased in both two groups.The expression of CEA decreased in the research group,while it was slightly higher in the control group.After statistical analysis,there was no statistically significant difference in the difference between CEA and CA19-9 before and after treatment in the two groups.The incidence of sensory neurological abnormalities,oral mucositis,hand-foot syndrome,and rash was higher in the study group.The grade ? and above adverse reactions such as sensory nerve abnormalities,oral mucositis,hand-foot syndrome,leukopenia,and neutropenia were higher in the study group.Univariate analysis showed that treatment programs,ECOG score,clinical stage and previous surgical history were the factors affecting OS in patients with gastric cancer.Cox multivariate regression analysis showed that the treatment programs(HR=0.525,95%CI:0.359-0.767,P=0.001),ECOG score(HR=3.910,95%CI:2.491-6.138,P<0.001),clinical stage(HR=4.835,95%CI:3.084-7.580,P<0.001)were independent prognostic factors.Conclusion:The median overall survival time was significantly increased in the DCX regimen group,as well as the disease control rate and one-year survival rate compared with DP regimen group.The grade ? and above hematologic toxicity such as leukopenia and neutropenia in the adverse reactions were higher in the study group,and non-hematologic toxicity such as sensory nerve abnormalities,oral mucositis,and hand-foot syndrome study group were higher than the control group.The intestinal mucosal barrier function damage is lighter in the study group.There was no significant difference in the reduction of CEA and CA19-9 levels between the two groups.ECOG score and clinical stage were independent prognostic factors for OS in patients with advanced gastric cancer.Compared to the DP regimen,using the DCX regimen can reduce the mortality risk.