三氧化二砷改善胃癌患者术后辅助化疗疗效同时减轻骨髓抑制(英文)

Arsenic trioxide enhances the therapeutic efficacy of adjuvant post-operative chemotherapy of gastric carcinoma while protecting bone marrow

Objective:The aim of the study was to investigate the prospective study if treatment with arsenic trioxide(As2O3) could enhance disease-free survival as adjuvant post-operative chemotherapy for gastric cancer patients and protect bone marrow from the negative effects of chemotherapy.Methods:84 adults were randomized into two groups.Patients in treatment group were treated with As2O3 and FOLFOX regimen,the other were administered with FOLFOX regimen only.Results:Four patients were withdrawn in treatment group after 3-4 cycles and the reasons were headache and fidgety(n = 2),arrhythmia(n = 1) and AST/ALT elevation(n = 1),while 1 patient in control group after 4 cycles for neutropenia.In the treatment group,the median DFS was 28.34 months(95% CI,25-33 months).While in control group,the median DFS was 24.50 months(95% CI,20-30 months).This difference was not statistically significant(chi-square:2.8885;P value:0.0892).Patients in the same subgroup of node-positive was 29 in the treatment group and 32 in control group,respectively.The median DFS was 27.87 months(95% CI,25-31 months) in the treatment group and 24.18 months(95% CI,19-31 months) in the control group with promising statistical significance(HR 1.89;chi-square:4.78;P value:0.0287).The most common grades 3-4 toxicity was leucopenia(n = 11) in control group and the difference was significant(chi-square:3.9768,P value:0.046) compared with that in treatment group(n = 4).Conclusion:The combination of arsenic trioxide and FOLFOX regimen has a potential advantage of enhancing disease-free survival in patients with gastric cancer in nodal-positive status as post-operative chemotherapy,and protect bone marrow from the negative effects of chemotherapy.

Objective： The aim of the study was to investigate the prospective study if treatment with arsenic trioxide （AS2O3） could enhance disease-free survival as adjuvant post-operative chemotherapy for gastric cancer patients and protect bone marrow from the negative effects of chemotherapy. Methods： 84 adults were randomized into two groups. Patients in treament group were treated with As2O3 and FOLFOX regimen, the other were administered with FOLFOX regimen only. Results： Four patients were withdrawn in treatment group after 3-4 cycles and the reasons were headache and fidgety （n = 2）, rhythmia （n = 1） and AST/ALT elevation （n = 1）, while 1 patient in control group after 4 cycles for neutropenia. In the treatment group, the median DFS was 28.34 months （95% CI, 25-33 months）. While in control group, the median DFS was 24.50 months （95% CI, 20-30 months）. This difference was not statistically significant （chi-square： 2.8885; P value： 0.0892）. Pa- tients in the same subgroup of node-positive was 29 in the treatment group and 32 in control group, respectively. The median DFS was 27.87 months （95% CI, 25-31 months） in the treatment group and 24.18 months （95% CI, 19-31 months） in the control group with promising statistical significance （HR 1.89; chi-square： 4.78; P value： 0.0287）. The most common grades 3-4 toxicity was leucopenia （n = 11） in control group and the difference was significant （chi-square： 3.9768, P value： 0.046） compared with that in treatment group （n = 4）. Conclusion： The combination of arsenic trioxide and FOLFOX regimen has a potential advantage of enhancing disease-free survival in patients with gastric cancer in nodal-positive status as post-operative chemotherapy, and protect bone marrow from the negative effects of chemotherapy.