Observation On The Efficacy And Safety Of Adjuvant Chemoradiotherapy In The Treatment Of Gastric Cancer

Objective To observe the efficacy and safety of radical gastrectomy combined with chemoradiotherapy and chemotherapy alone,and to balance the confounding factors of postoperative adjuvant chemoradiotherapy and chemotherapy group for gastric cancer by propensity score method.Metods A retrospective study was conducted on patients who received adjuvant chemoradiotherapy and chemotherapy after radical gastrectomy for gastric cancer in the first affiliated hospital of xinjiang medical university from July 2013 to July 2016.The relevant data of observation indexes were obtained by referring to the medical records and following up.The caliper value was set to 0.1 by the 1:1 nearest matching method for the analysis of tendency matching,and the efficacy and safety of the two postoperative adjuvant treatment methods were observed and analyzed.Outcome A total of 118 patients were collected in this study,including 69 in the chemoradiotherapy group and 49 in the chemoradiotherapy group.After the matching of tendency score,37 pairs of patients were successfully matched,and the observed variables between the two groups were balanced and comparable(P>0.05).The median progression-free survival time of the chemoradiotherapy group and the chemoradiotherapy group was35.0(27.9-42.1)months and 21.0(13.9-28.1)months,respectively,showing a statistically significant difference(X2=6.241,P=0.012).The progression-free survival time of the chemoradiotherapy group was longer than that of the chemotherapy group.There was no statistically significant difference in median survival time between the two groups(X2=0.639,P=0.424).During the treatment,the two groups had different degrees of adverse reactions,mainly mild adverse reactions.Among them,the abnormal rate of serum albumin hemoglobin leukocyte was statistically significant,and the abnormal rate of the chemoradiotherapy group was lower than that of the chemotherapy group(P<0.05),the abnormal rate of leukocyte in the chemoradiotherapy group was higher than that chemotherapy group,while the abnormal rate of albumin and hemoglobin in the chemotherapy group was higher than that chemoradiotherapy group.During the whole treatment period,all patients had different degrees of digestive tract reactions,the most common nausea and vomiting,and the incidence of abdominal pain in the chemotherapy group was lower than that in the chemoradiotherapy group,and the incidence of diarrhea was higher than that in the chemoradiotherapy group,and the difference was statistically significant(P<0.05).Conclusion The propensity scoring method successfully balanced the confounding factor distribution between the two groups,which ensured the comparability of the two groups.There were differences in the postoperative progression-free survival time between the two groups,while there were no significant differences in the overall survival time between the two groups.Postoperative combined chemoradiotherapy in gastric cancer patients can effectively reduce the rate of postoperative progression and prolong the progression-free survival time.Meanwhile,patients can tolerate the adverse reactions in the combined chemoradiotherapy,and the mostly incidence of adverse reactions is lower than that in the chemotherapy group.