Paclitaxel Or Irinotecan Monotherapy Or Combined With S-1 Second-line Treatment Of Advanced Gastric Cancer Clinical Study

Objective:To observe the clinical efficacy and side effects of paclitaxel or irinotecan monotherapy or combined with S-1 as second-line therapy for advanced gastric cancer.Methods :A retrospective analysis of our hospital from 2015-09 to 2017-06 with complete clinical data of 49 cases of advanced gastric cancer patients receiving single or combination of treatment;divided into single drug group and the combined group,of which single drug group 23 Cases,combined group of 26 cases.The single-agent group was given paclitaxel 175 mg / m2 or irinotecan 180 mg / m2 was administered intravenously on the first day,every 3 weeks;combination group: paclitaxel 135 mg / m2 intravenous infusion or irinotecan 120 mg / m2 was administered intravenously on the first day,S-1 was administered on a body surface area basis.When the body surface area was in the range of <1.25,1.25 to 1.50,and >1.50 m2,the single dose of tega was 40,50,and 60 mg,twice a day,the 1-14 days,every 3 weeks.After receiving at least two cycles of chemotherapy,the clinical efficacy and side effects of the two groups were compared according to RECIST 1.1criteria and NCI toxicity evaluation criteria.Results :The efficacy of all patients was evaluated.CR 1 cases,PR 1 cases,SD 4 cases,PD 17 cases,0RR 8.7% and DCR 26.1% in the single drug group.SD10 cases,PD 12 cases,ORR was 15.4%,DCR was 53.8% the two drugs group.There was no significant difference in ORR between two groups(P = 0.476),but disease control rate in the combination group was more superior(P = 0.048).The median PFS in the single drug group was 2.7 months.The median PFS in the combined group was 3.2 months.P = 0.194,the difference was not statistically significant.The median OS was 8.3months in the single drug group and9.8 months in the combined group,P = 0.195,the difference was not statistically significant.The side effects of the two groups were mainly hematological toxicity and gastrointestinal toxicity.The hematological toxicities of 1-2 grade were more common in the single drug group and the combination group,the hematological toxicities of 1-2 grade were 30.4%(7/23)and 42.3%(11/26)respectively,the P value was 0.390,There was no significant difference between the two groups in terms of non-hematological toxicity 1-2 grade gastrointestinal reactions more common,no significant difference(P = 0.069).There was no significant difference in grade 3-4 toxic and side effects between the two groups.Conclusion :There was no difference in the ORR between the combination group and the single drug group.Although there was no difference in statistics between the PFS and the OS,there was a tendency of prolongation,and the disease control rate was higher.There was no Significant differences incidence or severity of side effects in the two groups.