DOS方案与SOX方案用于Ⅲ期胃癌新辅助化疗的近期疗效比较

目的观察多西他赛、奥沙利铂联合替吉奥(DOS)与奥沙利铂联合替吉奥(SOX)方案用于ID期胃癌新辅助化疗的近期疗效和安全性方法回顾性分析2018年1月至2019年3月146例行围术期化疗的局部进展期胃癌患者的临床资料,31例术前化疗方案为DOS方案,115例术前化疗方案为SOX方案,比较两组新辅助化疗的安全性和近期疗效结果术后病理TRG评估DOS组化疗反应0级6例,1级7例,2级15例,3级3例,重度反应占比41.9%,中位无病生存期(DFS)18.5个月;SOX组化疗反应0级8例,1级15例,2级70例,3级22例,重度反应占比为20.0%,DFS20.8个月两组重度反应率差异有统计学意义(P<0.05),DFS差异无统计学意义(P>0.05)化疗主要不良反应为骨趙抑制、胃肠道反应、肝肾功能损害、脱发、周围神经病变和心脏毒性,其中,脱发发生率DOS组高于SOX组(P<0.05)两组手术时间差异有统计学意义(P<0.05),术中出血量,术后住院时间、术后引流时间、阳性淋巴结数,淋巴结检出数、R0切除率以及Clavien-Dindo≥3级并发症发生率差异均无统计学意义(P>0.05)结论对于DI期胃癌,多西他赛、奥沙利铂联合替吉奥方案可使患者获得更高的病理缓解程度,且具有良好的不良反应耐受,不增加围术期并发症,近期疗效不劣于奥沙利铂联合替吉奥方案。

Objective To compare the short-term effects between Docetaxel combined with Oxaliplatin,S-1 and Oxaliplatin combined with S-1 in neoadjuv.int chemotherapy in stage III gastric cancer after radical gastrectomy.Methods Clinical data of patients with locally advanced gastric-cancer tre«ited with perioperative chemotherapy from January 1,2018 to March 31,2019 in the department of gastric surgery,Cancer Hospital of the university of Chinese academy of sciences were analyzed retrospectively,and the safety and short-term efficacy of neoadjuvant chemotherapy of DOS and SOX were compared.Results There was a statistically significant difference in the mte of severe TRG response(grade 0 and grade 1)between the two groups(P<0.05),and no statistically significant difference in the median DFS(P>0.05).The main adverse re«ictions of chemotherapy were bone marrow suppression,gastrointestinal reaction,liver and kidney function damage,alopecia,peripheral neuropathy and cardiac toxicity.The incidence of alopecia in the DOS group was higher than that in the SOX group(P<0.05).The difference in operative time betrw^een the two groups was statistically significant(P<0.05).There was no statistically significant difference in blood loss,postoperative stay,postoperative drainage time,number of positive lymph nodes,number of lymph nodes,R0 resection rate,and Clavien-Dindo^grade 3 complication rate(P>0.05).Conclusion For stage III gastric cancer,Docetaxel combined with Oxaliplatin,S-1 regimen can make the patients a higher degree of pathological remission.The short-temi efficacy and safety are similar to Oxaliplatin combined with S-1 regimen.