Clinical Observational Study Of S-1Combined With Oxaliplatine And Tegafur Combined With Oxaliplatine As First-line Treatment For Advanced Gastric Cancer And Pathological Prognostic Factors

Combined with oxaliplatine： Gastric cancer is one of the commongastrointestinal cancer, when they diagnosed as having gastric cancer.,Thus losing theopportunity to cure the disease by surgical. At this time, the chemotherapycombination therapy is particularly important. But so far, gastric cancer is still a lackof so-called "standard" chemotherapy.Reasonable combination of chemotherapy drugs, and make it play the best effect,while minimizing the adverse reactions is the focus of current research. Gastriccommon chemotherapy drug is broadly divided into four categories: platinumsuch asoxaliplatin and S-1,5-fluoropyrimidine capecitabine. Since the anti-tumor activity ofcisplatin after1960, drug kinetics, cytotoxic and anti-tumor spectrum with cisplatin,carboplatin, there is a big difference. The most difference is oxaliplatin treatment oftumors resistant to cisplatin, carboplatin still active. And controlled observationbetween S-1plus oxaliplatin group, achieved a better clinical results, at the same timecan provide ideas for clinical work. A retrospective study of46cases of gastricclinicopathological parameters including the relationship between the gender, age,ECOG performance status at diagnosis, tumor pathological type, chemotherapy ofgastric cancer prognosis.Dosing regimens and methods: Collected between March2008to March2013,the Second Affiliated Hospital, Jilin University Bethune Medical School after S-1/oxaliplatin or the Tegafur/oxaliplatin group of46patients with advanced gastriccancer patients, observed group and the control group were treated with oxaliplatin.The specific medication methods are as follows: oxaliplatin130mg/m2, adding5%glucose injection500ml, continuous intravenous infusion of1.5hours, the first day; observation group while giving S-1. Specific medication as follows: S-140-60mg/m2administered (based on body surface area:>1.5m2,60mg/times;1.25m2-1.5m2,50mg/times;<1.25m2,40mg/times), each2times a day, before the breakfast andafter dinner,1-14days, and then having a rest for seven days,21days for a period.The control group while giving tegafur specific medication as follows:1g, from thefirst day to the fifth day, a slow intravenous injection. Each chemotherapy cyclenumber is at least two weeks; effectively required more than four cycles ofchemotherapy until the occurrence of intolerable toxicity or disease progression.Changes in the patient medication during weekly review of blood, liver and kidneyfunction, after2-cycle reviewing once CT scan detection of non-target lesions andtarget lesion. During chemotherapy are routinely given as prophylacticantiemetic,while dexamethasone prevention are given to prenwent the gastrointestinalreaction, and may enhance the first two antiemetic effect.parallel hepatoprotective andgastricprotective as symptomatic treatment, while B vitamins tablets takng orally. Theapplication during oxaliplatin asks patients to keep warm and to avoid cold diet, toavoid contact with cold items such as adverse stimuli. Combined with the clinical,pathological and follow-up data, and analysis of the following factors, includinggender, age, ECOG performance status at diagnosis,Results:46patients were ultimately completed177cycles of chemotherapy,combination chemotherapy completed3.9cycles per patient. Efficient alternative S-1/oxaliplatin group of21patients,38.5%(5/13), tegafur/oxaliplatin platinum groupof25patients, the efficiency of40.0%(6/15), disease control rate for S-1/theoxaliplatin group of96.2%(9/13), tegafur/oxaliplatin group,73.3%(11/15), Tumormarkers CEA and CA199were no statistical differences in the before and afterchemotherapy. Come to be further stratified by gender, age, ECOG performancestatus at diagnosis, tumor pathological type, chemotherapy survival of gastric cancer.ECOG score of the survival of the other were not statistically different. There is astatistically significant difference (P<0.05) in digestive reaction, tegafur groupcompared with the group of S-1nausea, vomiting and weight. Tumor markers CEAand CA199were no statistical differences in the before and after chemotherapy. Come to be further stratified by gender, age, ECOG performance status at diagnosis,tumor pathological type, lymph node metastasis, distant metastasis, lymph nodesoutside the soft tissue metastases, chemotherapy survival of gastric cancer. ECOGscore of the survival of the other were not statistically different.Conclusion: alternate S-1and oxaliplatin chemotherapy treatment of patientswith advanced gastric cancer, median survival time was10.1months. In contrast, thetotal effective rate of53%tumor control rate was70%, Toxicity is generally tolerated.In summary, S-1combined with L-OHP in the treatment of advanced gastric cancer,to avoid the risk of deep venous catheter may bring, which can improve the lives ofpatients quality, worthy of further promotion research. Average survival of46patientsenrolled, survival was behalf of fluoridation group survival of DeFazio group, COXmultivariate analysis derive that gender, age, histological type.