Clinical Study Of Capecitabine Maintenance Chemotherapy After The First-line Paclitaxel/Capecitabine Chemotherapy For Patients With Advanced Gastric Cancer

ObjectiveTo evaluate the efficacy and safety of paclitaxel plus capecitabine (PACX)withsubsequent capecitabine maintenance as the first-line chemotherapy for patients withadvanced gastric cancer.MethodsSeventy-six eligible patients were randomly assigned to group A and group B. Ingroup A36patient were treated with paclitaxel/capecitabine(PACX)regimen, repeated21days. Patients who responded to the therapy after4cycles were given capecitabinemaintenance(1000mg/m2, bid,d1~14,q3w) chemotherapy until disease progression orintolerable toxicity; while40patients in the group B were treated withcisplatin/capecitabine(XP) regimen, repeated21days. A maximum six-cycle wasgiven.ResultsThere was no significant difference in Remission Rate (RR) and Disease ControlRate (DCR) between PACX regimen and XP regimen (52.78%vs45.00%,80.56%vs75.00%, P=0.42). The RR and DCR were17.24%and72.4%in maintenance group,and0.00%and46.67%in follow-up group (P=0.006, P=0.043). The MedianProgression Free Survival Time (mPFS) in maintenance group was1.3mo longer than in follow-up group(8.10mo vs6.86mo, P=0.021).The Median Overall Survival Time(mOS) and one-year survival rate were2.41mo longer(14.74mo vs12.33mo)and21.08%higher(69.23%vs48.15%) than in follow-up group, but no statisticallysignificance was found(P=0.081, P=0.118).Compared with XP regimen, the incidencerate of alopecia and peripheral neurotoxicity in PACX regimen was significantlyhigher, but most of them were I/II degree. The incidence rate of nausea and vomitingwas lower in PACX regimen. In maintenance group, only the occurrence rate ofhand-foot syndrome was raised, the other toxicities were reduced obviously. Notreatment-related death was found.ConclusionPaclitaxel plus capecitabine with subsequent capecitabine maintenancechemotherapy can increase the RR and DCR, prolong the PFS and be liable to benefitthe OS and one-year survival rate, with good tolerance, more economic and safety. Itis valuable to some degree in the clinical application and further study was needed.