Adjuvant chemotherapy with S-1 plus oxaliplatin improves survival of patients with gastric cancer after D2 gastrectomy: A multicenter propensity score-matched study

AIM To investigate the safety and efficacy of S-1 plus oxaliplatin(SOX) as an adjuvant chemotherapy regimen in gastric cancer(GC) after D2 dissection.METHODS GC Patients who underwent D2 gastrectomy from September 2009 to December 2011 in four Chinese institutions were enrolled. Patients with stage ⅠB-ⅢC GC, who received adjuvant SOX treatment were matched by propensity scores with those who underwent surgery alone and those who conducted capecitabine plus oxaliplatin(XELOX) regimen. Disease-free survival(DFS) and overall survival(OS) were compared among the groups. In addition, adverse events in SOX patients were analyzed.Of 1944 GC patients who underwent D2 dissection, 867 were included for analysis. One hundred and seventeen patients treated with SOX were matched to 234 patients who conducted surgery alone. Fifty-seven patients treated with SOX were matched to 57 patients who received XELOX. The estimated five-year DFS was 57.5% in the adjuvant SOX group which was higher than that(44.6%) in the surgery alone group(P = 0.001); and the estimated five-year OS was 68.3% which was higher than that(45.8%) of surgery alone group(P < 0.001). Survival benefit was also revealed in stage III and > 60 years old subgroups(P < 0.001 and P = 0.015, respectively). Compared with XELOX regimen, SOX showed no significant difference in DFS(P = 0.340) and OS(P = 0.361). The most common ≥ 3 grade adverse events of SOX regimen were neutropenia(22.6%), leukopenia(8.9%) and thrombocytopenia(5.6%).CONCLUSION Compared with surgery alone, SOX regimen significantly improves the long-term survival and has acceptable toxicity in patients with stage ⅠB-ⅢC GC after D2 dissection. It may be a novel adjuvant chemotherapy regimen in GC patients.

Oxaliplatin combined with S-1 capsule in the treatment of 62 cases with advanced gastric cancer

Objective： The aim of this study was to evaluate the efficacy and safety profile of DeFazio （S-l） combined with oxaliplatin against unresectable advanced or metastatic gastric cancer. Methods： Oxaliplatin was given intravenously at 130 mg/m2 for 2 h on dl and S-1 was administered bid. at 80 mg/m2/day on d1-14 followed by a 7-day rest during the 3-week schedule. Results： All 62 patients were assessed for efficacy and adverse events. The response and disease control rates were 47.3% and 80.8%, respectively. The median time to progression was 7.8 months, and the median overall survival was 11.6 months. The grade 3/4 adverse events were hematological toxicities, including neutropenia （11.3%）, thrombocytopenia （9.7%） and gastrointestinal reactions （6.5%）. Conclusion： The SOX regimen （oxaliplatin, 130 mg/m2 d l; S-1, 80 mg/m2/day, bid. d1-14, q3w） provide a favorable efficacy and safety profile in patients with advanced gastric cancer.

PD-1抑制剂联合化疗一线新辅助治疗局部进展期胃腺癌的近期疗效及安全性评估

目的评估程序性死亡受体-1(PD-1)抑制剂联合奥沙利铂和替吉奥(SOX)方案在局部进展期胃腺癌患者新辅助治疗中的近期疗效和安全性。方法回顾性分析2020年1月1日至2022年1月31日于兰州大学第一医院收治的114例局部进展期胃腺癌患者的临床资料,根据治疗方案将患者分为PD-1抑制剂联合SOX组(联合组,35例)和SOX组(化疗组,79例),治疗后评估2组患者的近期疗效和不良反应。结果近期疗效方面,联合组与化疗组治疗后评估为完全缓解(CR)、主要病理缓解(MPR)、病理完全缓解(pCR)的患者比例相比分别为17.14%vs 3.79%(χ^(2)=4.247,P=0.039)、28.57%vs 12.66%(χ^(2)=4.246,P=0.039)、20.00%vs 6.33%(χ^(2)=4.813,P=0.028),差异均有统计学意义;2组之间客观缓解率(ORR)分别为71.43%和50.63%,差异有统计学意义(χ^(2)=4.280,P=0.039),疾病控制率(DCR)分别为100%和97.47%,差异无统计学意义;临床N分期的降期率分别为91.43%和56.96%,差异有统计学意义(χ^(2)=13.143,P<0.001)。不良反应方面,联合组和化疗组总不良反应及3级不良反应的发生率差异无统计学意义;在1~2级不良反应中,联合组转氨酶升高的发生率较高,差异有统计学意义;2组均未观察到4级不良反应及治疗相关死亡事件的发生。结论PD-1抑制剂联合SOX方案在局部进展期胃腺癌新辅助治疗中显示出显著的疗效和良好的安全性,可尝试作为其一线治疗的一种选择。

参芪扶正注射液联合SOX方案治疗晚期胃癌临床研究

目的:观察参芪扶正注射液联合SOX方案治疗晚期胃癌的临床疗效及安全性。方法:选取2013年11月—2015年11月本院确诊为晚期胃癌的患者61例,随机分为观察组31例和对照组30例。两组患者均采用SOX方案进行化疗,均给予对症支持治疗,观察组另给予参芪扶正注射液治疗。结果:观察组RR为74.19%,对照组RR为43.33%,观察组优于对照组(χ~2=6.003,P=0.014<0.05);观察组DCR为93.55%,对照组DCR为73.33%,观察组优于对照组(χ~2=4.546,P=0.033<0.05);观察组TTP、MST优于对照组(P<0.01);两组均未发生治疗相关性死亡,其毒副反应以消化道反应、骨髓抑制及周围神经毒性为主,且观察组不良反应发生率低于对照组(P<0.05或0.01)。结论:参芪扶正注射液联合SOX方案治疗晚期胃癌的临床疗效较好,不良反应发生率低,提高患者生存质量和延长生存期。

复方万年青胶囊联合SOX化疗方案治疗晚期胃癌的临床研究

目的观察复方万年青胶囊联合SOX化疗方案(奥沙利铂和替吉奥)治疗晚期胃癌的临床疗效。方法选择2018年3月—2021年2月中国人民武装警察部队河南省总队医院收治的107例晚期胃癌患者,根据随机数字表法分为对照组(53例)和治疗组(54例)。对照组采用SOX化疗方案治疗。第1天静脉滴注注射用奥沙利铂,130 mg/(m2·d),10%葡萄糖注射液500 mL稀释,静滴3 h,隔21 d治疗1次;同时当天温水送服替吉奥胶囊,80 mg/(m2·d),2次/d,连续14 d,停药7 d。治疗组在对照组基础上温水送服复方万年青胶囊,3粒/次,3次/d。两组均以21 d为1个治疗周期,连续治疗3个周期。观察两组疗效,比较两组生存质量、血清肿瘤标志物水平。结果治疗后,治疗组的临床总有效率(50.00%)、疾病控制率(85.19%)均高于对照组(30.19%、58.49%),组间对比差异有统计学意义(P<0.05)。治疗后,两组认知功能、角色功能、躯体功能、情绪功能、社会功能评分均显著升高(P<0.05);且治疗组认知功能、角色功能、躯体功能、情绪功能、社会功能评分均显著高于对照组(P<0.05)。治疗后,两组血清肿瘤相关物质群(TSGF)、糖类抗原-199(CA-199)、癌胚抗原(CEA)、糖链抗原724(CA724)水平均下降(P<0.05);且治疗组血清TSGF、CA-199、CEA、CA724水平低于对照组(P<0.05)。结论复方万年青胶囊联合SOX化疗方案治疗晚期胃癌可提高患者生活质量,降低血清肿瘤标志物水平,减少不良反应。

鸦胆子油软胶囊联合SOX方案治疗晚期结直肠癌的临床研究

目的研究鸦胆子油软胶囊联合SOX方案(奥沙利铂+替吉奥)治疗晚期结直肠癌的临床疗效。方法选取2018年8月-2019年8月在郑州大学附属洛阳中心医院治疗的80例晚期结直肠癌患者,所有患者随机分为对照组和治疗组,每组各40例。对照组患者入院后给予SOX方案治疗,第1~14天给予注射用奥沙利铂,推荐剂量130 mg/m^2,溶于500 mL 5%葡萄糖溶液中,输注时间小于3h;第1~21天口服替吉奥胶囊,1粒/次,2次/d。治疗组在对照组基础上口服鸦胆子油软胶囊,4粒/次,3次/d。21 d为1个治疗疗程,两组患者接受治疗3个疗程。观察两组的临床疗效,比较Karnofsky(KPS)评分、生活质量(QOL)评分及血清癌胚抗原(CEA)、基质金属蛋白酶(MMP)-2和MMP-9水平。结果经过治疗后,治疗组客观缓解率(ORR)和疾病控制率(CBR)显著高于对照组(P<0.05)。治疗后,两组患者KPS评分和QOL评分显著升高(P<0.05),且治疗组KPS评分和QOL评分升高程度较大(P<0.05)。治疗后,两组CEA、MMP-2和MMP-9水平显著降低(P<0.05);并且治疗组降低较多(P<0.05)。治疗组胃肠道反应、血小板减少、白细胞减少和转氨酶升高等不良反应发生率明显低于对照组(P<0.05)。结论鸦胆子油软胶囊联合SOX方案治疗晚期结直肠癌具有较好的治疗效果,能够提高患者生活质量,降低肿瘤标志物水平,安全性较高,值得在临床上推广应用。

健脾散结汤加味联合SOX化疗方案治疗晚期胃癌脾虚痰瘀证48例临床观察

目的观察健脾散结汤加味联合SOX化疗方案治疗晚期胃癌脾虚痰瘀证的临床疗效。方法将95例晚期胃癌脾虚痰瘀证患者采用随机数字表法分为对照组和治疗组,对照组47例采用SOX化疗方案治疗,治疗组48例在对照组治疗方法的基础上联合健脾散结汤加味治疗。治疗5个月后比较2组的临床疗效以及治疗前后的中医症状积分、Karnofsky功能状态量表(KPS)评分、白细胞计数、血红蛋白含量、血小板计数。结果治疗后2组中医症状积分明显降低,KPS评分明显升高,与同组治疗前比较,差异均有统计学意义(P<0.01),且治疗组改善作用更明显,与对照组治疗后比较差异均有统计学意义(P<0.01);采用SOX化疗方案治疗后2组白细胞计数、血红蛋白含量、血小板计数明显降低,与同组治疗前比较,差异均有统计学意义(P<0.01),但治疗后治疗组以上指标明显高于对照组,2组比较差异均有统计学意义(P<0.01);治疗组总改善率为93.75%(45/48),对照组为78.72%(37/47),2组比较差异有统计学意义(P<0.05)。结论健脾散结汤加味联合SOX化疗方案治疗晚期胃癌脾虚痰瘀证疗效确切,可明显改善患者的临床症状及生活质量,降低化疗后血液学毒性,值得临床推广应用。