| Objective:Weekly paclitaxel plus carboplatin solution(TP)used in stageⅢgastric cancer,chemotherapy efficacy and safety.Methods:Collected clinicalⅢperiod of 56 patients with gastric adenocarcinoma from the Department of Gastrointestinal Oncology,the First Affiliated Hospital of Hebei North University,between January 2014to December 2017.These patients were randomly divided into experimental group(TP group)and control group(SOX group).All patients underwent 3 cycles of neoadjuvant chemotherapy.Rest for 4weeks,re-examination and evaluation,and then D2 radical gastrectomy.Adjuvant chemotherapy was performed for 5 cycles followed up.TP group received weekly TP chemotherapy regimen(paclitaxel:80mg/m~2,IVGTT day 1 Carboplatin AUC=1.5 IVGTT day 1,Repeat every week,every 3 weeks for 1 cycle).SOX group received SOX regimen(oxaliplatin130mg/m~2,IVGTT day 1,Digio 60mg/time,twice/day,day 1-14 of PO,1cycle every 3 weeks).The main outcome indicators were as follows:(1)Efficacy evaluation indexes:overall response rate(ORR)of neoadjuvant chemotherapy,evaluation of pathological response,R0 resection rate,disease-free survival(DFS),and 3-year disease-free survival rate.(2)Safety evaluation indexes:toxicities and side effects of neoadjuvant chemotherapy,surgical mortality and complication rate.Results:A total of 56 cases were enrolled,and no dropout or loss of follow-up was found.(1)Comparison of efficacy:(1)results of efficacy evaluation for solid tumors,TP group:CR(3 cases),PR(19 cases),SD(5cases),PD(1 cases),the total effective rate ORR was 78.57%(22/28).SOX group:CR(2 cases),PR(12 cases),SD(13 cases),PD(1 case),the total effective rate ORR was 50.00%(14/28).The difference between the two groups was statistically significant(X~2=3.859,P=0.049;X~2=4.978,P=0.026).(2)The pathological response evaluation results showed that in the TP group,the pathological response rate was 85.71%(24/28),the pathological complete response rate was 10.71%(3/28),the rate of T stage reduction was 82.14%(23/28),and the rate of N stage reduction was71.43%(20/28).In SOX group,the pathological response rate was 67.86%(19/28),the pathological complete response rate was 3.57%(1/28),the T stage reduction rate was 75.00%(21/28),and the N stage reduction rate was 60.71%(17/28),with no statistical significance(P>0.05).(3)In TP group,R0 excision rate was 92.86%(26/28),SOX group:R0 excision rate was 85.71%(24/28),the difference was not statistically significant(P>0.05).(4)In the TP group,the median DFS was 37 months,and the 3-year disease free survival rate was 53.57%.In the SOX group,the median DFS was 25 months,and the 3-year disease free survival rate was 42.86%,the difference was statistically significant(X~2=4.173,P=0.041).(5)Cox regression analysis of variable lymph node metastasis and chemotherapy regimen,HR>1,indicated that they are risk factors affecting postoperative recurrence of gastric cancer patients.(2)Comparison of safety:(1)Toxic and side effects of chemotherapy:both of the two programs have high safety,without serious adverse reactions.The toxicity and side effects of SOX regimen were mainly gastrointestinal reactions such as nausea,vomiting and diarrhea,as well as leukopenia.The toxicological side effects,such as digestive tract reaction and bone marrow suppression of TP regimen were mild and well tolerated by patients,among which the comparison of digestive tract reaction results showed statistically significant difference(X~2=4.571,P=0.033;X~2=4.067,P=0.049).(2)There were no death cases and no serious postoperative complications in the two groups.Conclusion:weekly paclitaxel plus carboplatin solution applied toⅢstage gastric cancer chemotherapy has better efficacy and safety.ForⅢphase of chemotherapy regimens in patients with gastric cancer,more recommended TP solutions in a single week. |
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