Application Of TAX Combined With S-1 Regimen In Neoadjuvant Chemotherapy For Advanced Gastric Cancer

Objective:To observe the efficiency and safety of the TAX+S-1 regimen in the preoperative neoadjuvant therapy for advanced gastric cancer.To provides atheoretical basis for neoadjuvant chemotherapy for advanced gastric cancer.Methods:From October 2016 to December 2018,30 patients admitted to the department of oncology and oncology surgery of the affiliated hospital of Qinghai University were diagnosed as advanced(stage II and III)gastric cancer by CT and EUS pathology.Chemotherapy regimens is:TAX+S-1,TAX:175mg/m~2d1,S-1:If BSA<1.25m~2,S-1 is 40 mg PO BID,if BSA>1.5m~2,S-1 is 60mg PO BID,if1.25m~2<BSA<1.5m~2,S-1 is 50mg PO BID d1-14,give on every threeweeks,chemotherapy patients to give 2-4 cycles of chemotherapy,after again,D2 radical after chemotherapy evaluation after neoadjuvant chemotherapy in patients with efficient,adverse drug reaction after chemotherapy,tumor drop rate,detection of tumor markers CEA changes in new adjuvant chemotherapy in advanced gastric cancer,observe and record the patient's postoperative complications.Results:A total of 30 enrolled patients received neoadjuvant chemotherapy.E-valuation of efficacy after chemotherapy:the number of cases with CR was 0(0%),16 cases with PR(53.3%),12 cases with SD(40%),and 2 cases with PD(6.7%).The effective rate of RR was 53.3%.Adverse reactions after chemotherapy included:anaphylaxis in 2 cases(6.7%)and myelosuppression in 13 cases(43.3%),among which leukocytosis was the most common and obvious.Adverse reactions of digestive system:nausea and vomiting in 7 cases(23.3%),diarrhea in 3 cases(10.0%),constipation in 2 cases(6.7%).Other adverse reactions included:cardiovascular toxicity:hypotension in 1 case(3.3%),bradycardi-a in 1 case(3.3%);Neurotoxicity in3 cases(10.0%);Hepatotoxicity in 5 cases(16.7%);Renal toxicity:1 case(3.3%);No deaths occurred during neoadjuvant chemotherapy.These adverse reactions,mainly in grade I and grade II,were resolvedwith appropriate adjuvant treatment and care,and no deaths occurred during chemotherapy.25 patients(83.3%)underwent R0 resection,18 patients(60.0%)achieved tumor downstaging,and the pathological response rate to neoadjuvant chemotherapy was 56.7%.There were no operative deaths and 7 cases(23.3%)had postoperative complications.Postoperative complications include delayed gastric emptying,wound infection,deep venous thrombosis,peritoneal effusion,and intestinal obstruction.The mean level of tumor markers in 30 patients was lower than that before,and the changes were statistically significant(P<0.05).Conclusion:TAX combined with S-1 regimen is feasible and effective inpreoperative neoadjuvant chemotherapy for advanced gastric cancer.Although there are many adverse reactions after chemotherapy,these adverse reactions are mild and can be controlled by adjuvant treatment and pretreatment of chemotherapy.The average CEA level of tumor was lower than that before chemotherapy,and postoperative complications were less and controllable.TAX combined with S-1 regimen can be used as one of the neoadjuvant chemotherapy regimens for advanced gastric cancer.