Effect Of Neoadjuvant Chemotherapy (mDCF Regimen) On The Prognosis Of Patients With Advanced Gastric Cancer

Objective:Aim to investigate the effect of neoadjuvant chemotherapy?NACT??mDCF regimen?docetaxel+oxaliplatin+leucovorin+tegafur?on the efficacy and prognosis of patients with advanced gastric cancer,and observe the occurrence of adverse reactions.Methods:A retrospective analysis method was used to collect the clinical medical records of 63 patients with stage III advanced gastric cancer admitted to the Department of General Surgery,Lanzhou University Second Hospital from January2013 to January 2016,according to whether they received neoadjuvant chemotherapy,we could divided the patients into two groups:the observation group and the control group.the observation group was neoadjuvant chemotherapy plus surgical treatment?n=28?,systemic intravenous chemotherapy is given for 2 to 3 cycles,and the efficacy of chemotherapy is evaluated after the end of chemotherapy,followed by surgery.the control group was direct surgical treatment?n=35?.Through the case data and follow-up records,the number of R₀ resections,perioperative period,cumulative recurrence rate of 1 and 3 years,1 and 3 years survival rate and total survival time of the two groups were counted.Clinical data included age,gender,tumor location,histological type,histological grade,clinical pathological stage,Lauran classification,etc.Data analysis was performed using SPSS 22.0 software;paired chi-square?c2?test was used for comparison between groups;Kaplan-Meier method was used to plot survival rate and recurrence rate curve,log-rank test was used for survival curve comparison,and the difference was considered statistically significant at P<0.05.Result:1.Chemotherapy efficacy:Among the 28 patients in the observation group,complete response?CR?was performed in 0 case,partial response?PR?in 12 cases,stable disease?SD?in 14 cases,and progressive disease?PD?.2 cases.The overall response rate?CR+PR?was 42.9%,and the clinical benefit rate?CBR,CR+PR+SD?was 92.9%.In terms of toxic side effects,neoadjuvant chemotherapy patients during chemotherapy Because of the conventional administration of anti-allergic,antiemetic,and gastrointestinal mucosal drugs,the main side effects are myelosuppression,and I and II are mainly toxic and side effects,and no life-threatening adverse reactions occur.After stopping or It can return to normal after symptomatic treatment.2.R0 resection rate:Among the 28 patients in the observation group,the number of R0 resection cases was 26 cases,accounting for 92.9%.Among the 35 patients in the control group,the number of R0 resection cases was 31 cases,accounting for88.6%.The R0 resection rate of the two groups was compared.The difference was not statistically significant?P=0.565?.3.Cumulative recurrence rate:In the observation group,the 1-year cumulative recurrence rate was 14.3%,and the 3-year cumulative recurrence rate was 46.4%.In the control group,the 1-year recurrence rate was 37.1%,and the 3-year recurrence rate was 60.0%.The 1-year cumulative recurrence rate was statistically significant between the two groups?P=0.049?.The 3-year cumulative recurrence rate was not statistically significant between the two groups?P=0.028?.4.Survival rate:In the observation group,the 1-year survival rate was 92.9%,and the 3-year survival rate was 67.8%.In the control group,the 1-year survival rate was 88.6%,and the 3-year survival rate was 42.9%.The 1-year survival of the two groups was not statistically significant?P=0.565?.The 3-year survival rate of the two groups was statistically significant?P=0.048?.5.Overall survival:The survival time of the observation group was 9-61 months,and the median overall survival time was 38 months.The survival time of the control group was 7-58 months,and the median overall survival time was 29 months.The overall survival of the patients was statistically significant P<0.001?.Conclusion:According to the data analysis of this study,the results show that the treatment of stage III advanced gastric cancer1.Neoadjuvant chemotherapy?mDCF regimen?can reduce tumor volume,but does not significantly improve the patient's R0 resection rate;2.Neoadjuvant chemotherapy?mDCF regimen?can reduce the cumulative recurrence rate of stage III advanced gastric cancer,prolong the overall survival time,and improve the overall survival rate;3.The neoadjuvant chemotherapy?mDCF regimen?regimen did not produce serious adverse effects.