XELOX与SOX方案在胃癌辅助治疗中的临床观察

Clinical observation on the efficacy and safety of XELOX and SOX as adjuvant chemotherapy in patients of gastric cancer

目的:观察XELOX方案和SOX方案在胃癌辅助治疗中的疗效和安全性。方法:回顾性收集2015年1月~2017年9月在我院行术后辅助化疗的99例Ⅱ/Ⅲ期胃癌患者的临床资料。观察接受XELOX及SOX两种不同方案化疗患者的无病生存期、总生存期及化疗不良反应。结果:XELOX组和SOX组的3年无病生存(DPS)率和总生存(OS)率相似(69.70%vs.68.18%,P=0.839;81.82%vs.80.30%,P=0.859)。在各亚组中,XELOX组与SOX组的DFS率及OS率差异无统计学意义。SOX组患者腹膜转移的发生率低于XELOX组,但差异无统计学意义。多因素分析显示,Lauren分型、淋巴结转移数目及淋巴结阳性比例(LNR)是患者DFS的独立预后因素,而淋巴结转移数目和LNR是患者OS的独立预后因素。两组不良反应发生率相似,XELOX组手足综合征的发生率高于SOX组,但可耐受。结论:XELOX及SOX用于D2根治术后患者的辅助化疗,3年的DFS率和OS率接近。两种方案不良反应相似,均可耐受。淋巴结转移数目及LNR是患者生存的独立预后因素。

Objective:To compare the efficacy and safety of XELOX and SOX regimen as adjuvant chemotherapy in patients of gastric cancer.Methods:Clinical data were obtained from 99 cases of stage II/III gastric cancer undergone adjuvant chemotherapy in our hospital between January 2015 and September 2017.The disease free survival(DFS),overall survival(OS)and adverse events were examined in the patients treated by the two chemotherapy regimens.Results:The 3-year DFS rate and 3-year OS rate were proportional in XELOX group to SOX group(69.70%vs.68.18%,P=0.839;81.82%vs.80.30%,P=0.859),and there was no significant difference in the DFS rate and OS rate between XELOX group and SOX group in each subgroup.The incidence of peritoneal metastasis was lower in SOX group than in XELOX group,yet the difference was insignificant.Multivariate analysis revealed that Lauren classification,lymph node metastases and lymph node ratio(LNR)were independent prognostic factors for patients with DFS,whereas the number of lymph node metastases and LNR were independent factor to estimate the OS.Although the adverse events were similar in XELOX and SOX groups,yet the incidence of hand-foot syndrome in the SOX group was significantly higher than that in the XELOX group,and the adverse effects in both regimens were in tolerance.Conclusion:XELOX and SOX have similar curative effects in patients with gastric cancer following D2 gastrectomy.The 3-year DFS rate and 3-year OS rate are similar,and both regimens are well-tolerated.The number of lymph node metastases and LNR are independent prognostic factors for the survival of patients.