Observations Of The Efficacy And Adverse Events Of Maintenance Treatment Using Capecitabine Or S-1in Advanced Gastric Cancer Patients

Purpose: Though maintenance therapy has been used in treatment of several types ofcancers for its favorable clinical benefits, seldom study addressed its role in thetreatment of advanced gastric cancer (AGC). This study regarded the AGC patientswho had received certain cycles (two-week regimen6to9cycles or three-weekregimen4to6cycles) of combined chemotherapy as first-line treatment and achieveddisease control as study objects, and discussed the efficacy and adverse events ofcapecitabine (CAP) or S-1as maintenance chemotherapy for AGC.Materials and Methods: All newly diagnosed patients with AGC referred fortreatment to the Oncology unit at Fujian Medical University Union Hospital fromJanuary2009to May2013were analyzed. All patients had accepted certain cycles(two-week regimen6to9cycles or three-week regimen4to6cycles) of combinedchemotherapy as first-line treatment and achieved disease control [Including completeremission (CR)、 partial remission (PR) or stable disease (SD)].75patients withoutfurther chemotherapy after completion of certain cycles of induction chemotherapywere regarded as observation group,45patients received CAP or S-1were regardedas maintenance group.Results:--The median PFS of maintenance group was9.57months, the median PFSof observation group was6.40months, the difference between them was statisticallysignificant(P=0.002). In maintenance treatment, the incidence of grade3adverseevent was6.6%, there was no grade4adverse event or death related to chemotherapy.Subgroup analysis：（1）The median PFS of patients with CR and PR, and SD were9.53months and9.70months(P=0.64) in maintenance group, while7.47monthsand6.33months(P=0.21) in observation group, the difference was not statistically significant.（2）The median PFS of the three subgroups were7.57months,9.73months and9.33months in maintenance group (P=0.69), while7.70months、7.00months and6.17months in observation group (P=0.32), the difference was notstatistically significant.Conclusion: For the AGC patients who had received certain cycles (two-weekregimen6to9cycles or three-week regimen4to6cycles) of combinedchemotherapy as first-line treatment and achieved disease control, the oralfluorouracil drug represented by CAP or S-1as maintenance treatment wasefficacious, resulted in significantly prolonged PFS and the adverse event wastolerable.