胃癌术后FOLFOX6方案与XELOX方案辅助化疗的生存比较

Comparison of patient survival on adjuvant FOLFOX6 and XELOX chemotherapy after resection for gastric cancer

目的：比较可切除胃癌患者术后分别采用奥沙利铂联合5-氟尿嘧啶/亚叶酸钙（FOLFOX6）与奥沙利铂联合卡培他滨（XELOX）两种方案辅助化疗的生存差异。方法：147例Ⅰ～Ⅲ期胃癌术后（R0切除）患者接受治疗，其中FOLFOX6组99例， XELOX组48例，比较两组不良反应率和生存率。结果：FOLFOX6组白细胞减少及肝功能异常的发生率明显高于XELOX组（P〈0.05），XELOX组手足综合征（HFS）的发生明显高于FOLFOX6组（P=0.016），其它不良反应的比较，包括贫血、血小板减少、恶心呕吐、腹泻、肾功能异常、外周神经毒性、口腔黏膜炎等差异无统计学意义（P〉0.05）。FOLFOX6组与XELOX组1、3、5年无病生存率（DFS）分别为81.7%、49.5%、39.8%和93.8%、52.1%、33.8%，两组中位无病生存时间（mDFS）分别为35、38个月，差异无统计学意义（P=0.672）；FOLFOX6组与XELOX组1、3、5年总生存率（OS）分别为98.0%、68.1%、44.6%和97.8%、78.7%、44.7%，两组中位总生存时间（mOS）分别为55、58个月，比较亦无显著性差异（P=0.194）。结论：两种化疗方案对胃癌患者远期生存的影响无显著性差异。

Objective：To compare the survival of resected gastric cancer patient treated with oxaliplatin, 5-fluorouracil, and leu-covorin （FOLFOX6） with those treated with oxaliplatin and capecitabine （XELOX）. Methods：A total of 147 resected gastric cancer pa-tients accepted the treatment. Among them, 99 were treated with FOLFOX6 and 48 were treated with XELOX. Adverse events and sur-vival rates of the two groups were compared. Results：Incidence of leukopenia and hepatic dysfunction in the FOLFOX6 group was sig-nificantly higher than that of the XELOX group （P〈0.05）, whereas hand-foot syndrome in the XELOX group was significantly higher than that of the FOLFOX6 group （P=0.016）. By contrast, the incidence of other adverse events, such as anemia, thrombocytopenia, nau-sea and vomiting, diarrhea, kidney dysfunction, peripheral neurovirulence, and oral mucositis, was not significantly different （P〉0.05） between the two groups. After 1, 3, and 5 years, disease-free and overall survivals between the two groups were not significantly differ-ent （P〉0.05）. Conclusion：The effects of FOLFOX6 and XELOX adjuvant chemotherapies on long-term survival of resected gastric cancer patients were found to have no significant difference.