Application Of Apatinib Combined With DOS Chemotherapy In Neoadjuvant Treatment Of Stage ? Gastric Cancer

Objective:To observe the clinical efficacy and safety of oral apatinib combined with intravenous infusion of docetaxel(txt),oxaliplatin(L-OHP)and oral tegio capsule in the treatment of stage ? gastric cancer.Method:78 patients with stage ?A-?C gastric cancer admitted to gastrointestinal surgery of our hospital from February 6,2017 to February24,2019 were collected and divided into two groups: apatinib combined with docetaxel(TXT),oxaliplatin(L-OHP)and tegio(experimental group,40 cases)and docetaxel alone with oxaliplatin(L-OHP)and tegio(control group,38 cases).All patients completed one cycle or more neoadjuvant chemotherapy until disease is progressing or the adverse reactions are intolerable.The clinical effect after chemotherapy,the adverse reactions of neoadjuvant chemotherapy and the operation effect after neoadjuvant chemotherapy were compared and analyzed.Result: The experimental group's objective remission rate(ORR)was 60.0%,which was higher than the control group's objective remission rate(ORR)(36.8%).There were some statistically significant differences.(P = 0.04 < 0.05);The incidence of major adverse reactions such as myelosuppression,nausea,diarrhea,liver dysfunction and skin allergy were compared between the two groups: The experimental group's myelosuppression incidence was lower than the control group's myelosuppression incidence.The statistical difference was significant.(P= 0.04 < 0.05)And the experimental group's skin allergy incidence was higher than the control group's incidence of skin allergy.The difference was statistically significant.(P = 0.02 < 0.05)There was no statistical significance in other differences;The radical resection rates of the experimental group and the control group after neoadjuvant chemotherapy were 82.5% and 60.5% respectively,the difference was statistically significant(P = 0.03 < 0.05);The experimental group's positive rate of lymph nodes was lower than the control group's positive rate of lymph nodes.The difference was statistically significant.(P = 0.015 < 0.05);The main postoperative complications were anastomotic leakage,anastomotic obstruction,anemia,obstructive jaundice and so on.There was no significant difference between the experimental group and the control group(P > 0.05);The quality of life between the experimental group and the control group was not different(P > 0.05).Conclusion:The efficacy of combination of apatinib with docetaxel(TXT),oxaliplatin(L-OHP)and tegio in the treatment of stage ? gastric cancer is better than that of only docetaxel(TXT),oxaliplatin(L-OHP) and tegio,which can reduce the tumor volume,improve the radical resection rate of stage ? gastric cancer and reduce the positive rate of lymph node metastasis.The adverse reactions of apatinib combined with docetaxel(TXT)and oxaliplatin(L-OHP)group were less than those of docetaxel(TXT)and oxaliplatin(L-OHP)and tegio only,which could be tolerated.It is worthy of further clinical research and application.