| Objective: Currently,perioperative chemotherapy is widely recogniz ed for the treatment of advanced gastric cancer,and the two-drug regim en combining fluorouracil and platinum has long occupied a place.A la rge number of studies have reported that the combination of three drugs has better efficacy,but the safety needs to be studied.The purpose of t his study was to evaluate the docetaxel combined with oxaliplatin and c apecitabine three-drug regimen(DOX protocol)and oxaliplatin and cape citabine two-drug regimen(XELOX protocol)in the progression of gastr ic cancer.The safety of surgical chemotherapy is good and bad,so it p rovides some guidance for the choice of perioperative chemotherapy in patients with advanced gastric cancer.Methods: From September 2014 to September 2019,a prospective,open,randomized controlled phase III clinical trial of the Fourth Hospit al of Hebei Medical University,randomly enrolled 196 patients with ad vanced gastric cancer into A and B Groups C and C,group A(68 cas es)received preoperative DOX plan + surgery + postoperative XELOX plan,group B(64 cases)received preoperative XELOX plan + surgery + postoperative XELOX plan,group C(64 patients)received Surgery +postoperative XELOX protocol,collect clinical data of patients in the gr oup,and analyze the adverse reactions during chemotherapy,compare th e incidence of adverse reactions between chemotherapy in groups A and B,B and C,and in group A,B The incidence of adverse reactions bef ore and after surgery in the group,the completion of chemotherapy in t he three groups and the influencing factors of the occurrence of adversereactions above 3 degrees were evaluated.Results:1 Comparison between A and B groups: 1)1 to 2 degrees of leuk openia,oral mucositis,hair loss,and peripheral neuritis were higher in group A than in group B,the difference was statistically significant(P < 0.05);2)chemotherapy was completed in group A The rate(48/68,70.59%)was similar to the completion rate of chemotherapy in group B(45/64,70.31%);the number of chemotherapy completion cycles in gro up A was similar to the number of chemotherapy completion cycles in group B.The difference was not statistically significant(P > 0.05).2 Comparison between group B and group C: 1)3 ? 4 degree of n ausea and vomiting,group C was higher than group B,the difference was statistically significant(P < 0.05).The incidence of 1-2 degrees of constipation in group B was higher than that in group C,and the diff erence was statistically significant(P < 0.05).2)the chemotherapy com pletion rate of group B(45/64,70.31%)was higher than that of group C(29/56,51.78%).The number of completed cycles of chemotherapy i n group B was higher than that in group C,and the difference was s tatistically significant(P < 0.05).3 Comparison of group A and group before and after surgery: 1)1to 2 degree leukopenia,neutropenia,anemia,thrombocytopenia,total bil irubin,nausea,3 to 4 degree leukopenia,neutrophils Cell reduction,glut amine,aspartate aminotransferase elevation,nausea,vomiting,and hand and foot syndrome were significantly higher after surgery than before su rgery,the differences were statistically significant(P < 0.05);2)1 to 2degrees oral mucositis,hair loss,Peripheral neuritis was higher than that before surgery,and the difference was statistically significant(P < 0.05).4 Comparison of group B before and after surgery: 1)1 to 2 degr ee leukopenia,neutropenia,anemia,elevated total bilirubin,alanine,aspa rtate aminotransferase,vomiting,hand and foot syndrome,3 ? 4 degrees of alanine aminotransferase elevation,nausea were significantly higher after surgery than before surgery,the difference was statistically signific ant(P < 0.05);2)1 to 2 degrees of constipation were higher than bef ore surgery,the difference was statistically significant(P < 0.05).5 Analyze the factors that affect the occurrence of adverse reaction s above 3 degrees: 1)Older,female and obese patients are more likely to have adverse reactions above 3 degrees than young,male,normal o r light patients,the difference is statistically significant(P < 0.05).2)Multivariate Logistic regression analysis showed that age and gender we re independent risk factors affecting the occurrence of adverse reactions above 3 degrees(P < 0.05).Conclusion:1.Patients with advanced gastric cancer during the perioperative peri od of treatment with DOX and XELOX chemotherapy are safe and well tolerated.2.DOX and XELOX treatment of advanced gastric cancer,preoperat ive neoadjuvant chemotherapy can improve the completion rate of chem otherapy compared with postoperative adjuvant chemotherapy,and it is s afer.3.Compared with the two-drug combination regimen,the three-drug combination regimen has a higher incidence of 1-2 degree leukopenia,h air loss,oral mucositis,and peripheral neuritis,but the adverse reactions can be tolerated.4.Elderly,female and obese patients are more likely to have advers e reactions above 3 degrees,and age and gender are independent risk f actors that affect the occurrence of adverse reactions above 3 degrees.More attention should be paid to chemotherapy for these patients. |
PDF Full Text Request