| [Objective] postoperative adjuvant treatment for resectable gastric cancer have been confirmed,but there is not gold standard regimen currently.This study aim to evaluate the efficacy and safety for mFOLFOX or Taxol+CF/5-Fu as postoperative adjuvant treatment for resectable gastric cancer,and evaluate the different therapeutic results of them in intestinal-type gastric cancer and diffuse-type gastric cancer.[Methods] 131 patients with radical gastric caner were enrolled,include 54 intestinal- type gastric cancer patients,58 diffuse-type gastric cancer patients,19 hybrid-type gastric cancer patients.In all patients,70 patients were enrolled in mFOLFOX regimen(A arm),while the other 61 patients were enrolled in Taxol+CF/5-Fu regimen(B arm).In intestinal-type gastric cancer patients,28 patients were enrolled in mFOLFOX regimen(A1 arm),while the other 26 patients were enrolled in Taxol+CF/5-Fu regimen(B1 arm).In diffuse-type gastric cancer patients,30 patients were enrolled in mFOLFOX regimen(A2 arm),while the other 28 patients were enrolled in Taxol+CF/5-Fu regimen(B2 arm).mFOLFOX regimen:intravenous infusion of oxaliplatin 85mg/m2 for 2h on day 1,intravenous infusion of leucovorin 200mg/m2 for 2h on day 1-2,and continuous infusion of 5-Fu 2.4g/m2 for 48h,14days/cycles. Taxol+CF/5-Fu regimen:intravenous infusion of paclitaxel 95mg/m2 for 2h on day 1,intravenous infusion of leucovorin 200mg/m2 for 2h on day 1-2,and continuous infusion of 5-Fu 2.4g/m2 for 48h,14days/cycles. We evaluate the DFS、OS and side effect of them.[Results] In therapeutic effect, one-year,two-year,three-year disease free survival rate of A arm and B arm are 81.4% vs 80.3%(P=0.873),68.5%vs67.2%(P=0.868),58.6% vs59.0% (P=0.959) respectively.One-year,two-year,three-year overall survival rate of A arm and B arm are 94.3%vs96.7%(P=0.506),81.4%vs78.7%(P=0.695),75.7%vs72.1%(P=0.641) respectively. In the aspect of the adverse event,there are nausea, vomiting, diarrhea, constipation, leukopenia,neutropenia,thrombocytopenia,anemia, liver dysfunction.No grade Ⅳadverse event is accurred. Grade Ⅲ adverse event of A arm and B arm are 6.5%,5.9% respectively.Peripheral neuropathy of A arm is significantly increased than B arm,other adverse events are not statistically significant.In intestinal-type gastric cancer patients, disease free survival of A1 arm is Significantly prolong than B1 arm(P=0.006),overall survival of them is not statistically significant(P=0.537).One-year,two-year,three-year disease free survival rate of A1 arm and B1 arm are85.7%vs73.1%(P=0.248),78.6%vs53.8%(P=0.054), 71.4%vs42.3%(P=0.031) respectively.One-year,two-year,three-year overall survival rate of A1 arm and B1 arm are96.4%vs92.3%(P=0.509),89.3% vs73.1%(P=0.125) ,85.7%vs65.4%(P=0.081) respectively.In diffuse-type gastric cancer patients, disease free survival of B2 arm is significantly prolong than A2 arm(P=0.021),overall survival of them is not statistically significant(P=0.247).One-year,two-year,three-year disease free survival rate of A2 arm and B2arm are 76.7% vs89.3%(P=0.204),60.0% vs78.6%(P=0.127), 46.7%vs75%(P=0.028)respectively.One-year,two-year disease,three-year overall survival rate of A2 arm and B2 arm are93.3%vs100%(P=0.164),76.7%vs85.7%(P=0.380), 70.0%vs78.6%(P=0.456)respectively.[Conclusion] 1.mFOLFOX regimen and Taxol+CF/5-Fu regimen should be considered as a postoperative adjuvant treatment option for patients with resectable gastric cancer becauce of good effect and safety.2.mFOLFOX regimen is better for intestinal-type gastric cancer patients and Taxol+CF/5-FU regimen is better for diffuse-type gastric cancer patients. |
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