胃癌新辅助化疗中DOX与mFOLFOX6方案的疗效和安全性对比分析

Comparison and analysis of the efficacy and safety of DOX and m FOLFOX6 in neoadjuvant chemotherapy for gastric cancer

目的比较mFOLFOX6(奥沙利铂+氟尿嘧啶)和DOX(多西他赛+奥沙利铂+卡培他滨)两种新辅助化疗方案对局部晚期胃癌患者的疗效及安全性。方法回顾性分析2014年10月至2017年12月入住本院72例确诊为局部晚期胃癌患者,采用新辅助化疗,其中36例采用mFOLFOX6方案,36例采用DOX方案,化疗3个周期后进行临床疗效的判定并分析其不良反应。结果 mFOLFOX6组36例患者中,临床缓解率为27.8%(10/36),疾病控制率为63.9%(23/36);DOX组36例患者中,临床缓解率为36.1%(13/36),疾病控制率为75.0%(27/36),两组的近期临床疗效相比差异无统计学意义(均P>0.05);mFOLFOX6组根治手术R0切除率为66.7%(24/36),DOX组为77.8%(28/36),两组患者的根治手术R0切除率比较差异无统计学意义(P>0.05);DOX方案组呕吐、白细胞减少、血小板减少及手足综合征发生率明显高于mFOLFOX6方案组,差异均有统计学意义(P<0.05)。结论 mFOLFOX6两药方案与DOX三药联合方案在胃癌新辅助化疗中疗效相近,但DOX方案消化道反应及血液学毒性的发生率更高。

Objective To compare the efficacy and safety of DOX (docetaxel + oxaliplatin + capecitabine) program with mFOLFOX6(oxaliplatin + fluorouracil) program as neoadjuvant chemotherapy in locally advanced gastric cancer patients. Methods 72 patients who was diagnosed as local advanced gastric cancer in our hospital from October 2014 to December 2017, were treated by neoadjuvant chemotherapy, 36 of which were mFOLFOX6, and 36 were DOX. After 3 cycles of chemotherapy, the clinical efficacy was determined and the adverse reactions were analyzed. Results In the 36 cases of mFOLFOX6 group, the clinical remission rate was 27.8%(10/ 36), and the tumor control rate was 63.9%(23/ 36). Among the 36 patients in the DOX group, the clinical remission rate was 36.1%(13/36), and the tumor control rate was 75.0%(27/36). The recent clinical efficacy of the two groups were not statistically significant (both P>0.05). The R0 cutting rate of mFOLFOX6 group was 66.7%(24/36), and the DOX group was 77.8%(28/36). There was no statistically significant difference between the R0 cut rate of the radical operation of the two groups (both P>0.05). The incidence of nausea, vomiting and leukocyte reduction in DOX group was significantly higher than that in the mFOLFOX6 group, and the difference was statistically significant (all P<0.05). Conclusions The combination of mFOLFOX6 and DOX is similar in the treatment of neoadjuvant chemotherapy in gastric cancer, but the incidence of gastrointestinal reaction and hematological toxicity in DOX scheme is higher.