Analysis Of Clinical Efficacy And Safety Of Docetaxel Or Irinotecan Combined With Oxaliplatin And S-1 In The Treatment Of Advanced Gastric Cancer

Objective: To observe the clinical efficiency and safety of docetaxel(TXT)or irinotecan(CPT-11)combined with oxaliplatin(L-OHP)and S-1 in the treatment of advanced gastric cancer.Methods : Totally 62 cases of patients with stage ?B-? advanced gastric cancer in the department of gastrointestinal surgery of The First Affiliated Hospital of Chongqing Medical University were collected from 1st January 2010 to 1st March 2016,and were divided into two groups: TXT combined with L-OHP and S-1 group(modified DCF group,33 patients)and CPT-11 combined with L-OHP and S-1 group(modified ICF group,29 patients).All patients in the two groups were completed at least 1 cycle of chemotherapy until disease progression or intolerable toxicity.At the end of chemotherapy,the curative effects,untoward reactions and effects of surgery after neoadjuvant chemotherapy treatment were compared and analyzed.Results: The objective response rate(ORR)in the,modified DCF group(60.6%)was higher than that in the modified ICF group(51.7%),while no statistically significant difference was found in short-term effects between the two groups(Z=-0.837,P=0.403).There were no statistically significant differences in the incidences of main untoward reactions,including gastrointestinal reaction,myelosuppression,neurotoxicity,alopecia and liver function abnormal,between the two groups(P>0.05).The radical resection rate of the modified DCF group and the modified ICF group after neoadjuvant chemotherapy was 66.7% and 62.1% respectively,the difference between the two groups was not statistically significant(?2=0.143,P=0.706).After neoadjuvant chemotherapy,no statistically significant differences were found in the incidences of main postoperative complications,including anastomotic leakage,anastomotic obstruction,abdominal infection,pulmonary infection,incision infection and gastric motility disorder,between the two groups(P> 0.05).There was no statistically significant difference in quality of life after chemotherapy between the two groups(P>0.05).Conclusion : TXT or CPT-11 combined with L-OHP and S-1 has similar efficacy in the treatment of advanced gastric cancer,which could rreduce the primary tumor and regional lymph nodes of advanced gastric cancer and reduce the tumor size,so as to improve the radical resection rat.Furthermore,untoward adverse reactions of the two neoadjuvant chemotherapy protocols are almost the same,and can be tolerated.It is worthy of further clinical research,and reasonable use of patients.