SOX与FOLFOX6化疗方案在局部进展期胃癌手术患者中的应用比较

Comparisons of SOX and FOLFOX6 chemotherapies on operative treatment of locally advanced gastric cancer

目的:比较分析奥沙利铂联合替吉奥(SOX方案)与奥沙利铂联合亚叶酸钙、氟尿嘧啶(FOLFOX6方案)新辅助化疗在局部进展期胃癌手术患者的疗效、术后转归及生存情况等差异。方法:回顾性分析2012年1月至2013年8月接受SOX与FOLFOX6化疗方案的87例局部进展期胃癌手术患者资料,按化疗方案,将患者划分为观察组(SOX方案,45例)和对照组(FOLFOX6方案,42例)。比较2组化疗效果、不良反应、手术情况、术后转归、并发症及生存情况等差异。结果:2组化疗方案的疗效、D2淋巴结清扫率、R0切除率、术后并发症发生率、病理退缩分级对比,差异均无统计学意义(P>0.05)。2组化疗期间均未见Ⅲ~Ⅳ级不良反应,观察组化疗期间Ⅰ~Ⅱ级恶心呕吐、腹泻发生率低于对照组,差异有统计学意义(35.56%vs. 73.81%,χ^2=12.799,P=0.000;6.67%vs. 30.95%,χ^2=8.537,P=0.003)。观察组1年、3年、5年无进展生存率分别为95.56%、55.56%、28.89%,对照组分别为92.86%、45.24%、23.81%,2组比较差异无统计学意义(logrankχ^2=0.474,P=0.491);观察组1年、3年、5年累积生存率分别为97.78%、62.22%、31.11%,对照组分别为97.62%、50.00%、26.19%,2组比较差异无统计学意义(logrankχ^2=0.666,P=0.414)。结论:SOX方案用于局部进展期胃癌化疗,疗效与FOLFOX6方案接近,但胃肠道不良反应风险轻于后者,推荐临床应用。

Objective:To compare differences of clinical efficacy,postoperative outcomes and survival between the oxaliplatin combined with tegafur(SOX) and the oxaliplatin combined with calcium folinate and fluorouracil(FOLFOX6) neoadjuvant chemotherapies in patients with locally advanced gastric cancer. Methods:From January 2012 to August 2013,data of 87 patients with locally advanced gastric cancer underwent operation and received SOX and FOLFOX6 chemotherapies were retrospectively analyzed. According to chemotherapy scheme,these patients were divided into the observation group(SOX,n=45) and the control group(FOLFOX6,n=42).Chemotherapeutic efficacy,adverse reactions,surgical conditions,postoperative outcomes,complications and survival conditions in two groups were compared. Results:There were no significant differences in chemotherapeutic efficacy,dissection rate of D2 lymph node,R0 dissection rate,incidence rate of postoperative complications and pathological tumor regression grade between two groups(P > 0.05).There were no adverse reactions of Ⅲ-Ⅳ level in two groups. The incidence of nausea,vomiting and diarrhea (Ⅰ-Ⅱ level) during chemotherapy in the observation group was significantly lower than that in the control group(35.56% vs. 73.81%,χ^2=12.799,P=0.000;6.67% vs. 30.95%, χ^2=8.537,P=0.003). The progression-free survival rate in the observation group at 1,3,5 years were 95.56%,55.56%,28.89%,respectively;those in the control group at 1,3,5 years were 92.86%,45.24%,23.81%,respectively,without statistically significant differences(logrank χ^2=0.474,P=0.491). The cumulative survival rate in the observation group at 1,3,5 years were97.78%,62.22%,31.11%,respectively;those in the control group at 1,3,5 years were 97.62%,50.00%,26.19%,respectively,without statistically significant differences(logrank χ^2=0.666,P=0.414). Conclusion:For treating the locally advanced gastric cancer,SOX has a similar efficacy FOLFOX6,but has amilder risk of gastrointestinal adverse reactions recommending for clinical use.