Clinical Study Of Capecitabine Or S-1 Combined With Oxaliplatin In The Treatment Of Postoperative Recurrence Or Metastasis Of Gastric Cancer

Objective:To compare the efficacy and safety of capecitabine plus oxaliplatin(XELOX)and S-1 plus oxaliplatin(SOX)in the treatment of postoperative recurrence or metastasis of gastric cancer.Methods:1.Clinical information:106 cases of postoperative recurrence or metastasis of gastric cancer treated in our hospital from January 2013 to December 2015 were selected.By randomly divided into Xelox arm and SOX arm,53 cases in each arm.In the Xelox arm,there were 30 males and 23 females,aged 37 to 78 years,mean age(56.62 ± 12.26)years,32 cases of adenocarcinoma,5 cases of signet ring cell carcinoma,8 cases of adenocarcinoma with signet ring cell carcinoma,and other 8 cases.In th SOX arm,there were 29 males and 24 females,aged 38 to 76 years,mean age(56.29 ± 12.58)years,34 cases of adenocarcinoma,4 cases of signet ring cell carcinoma,7 cases of adenocarcinoma with signet ring cell carcinoma,and other 8 cases;2.Regimen:(1)In the Xelox arm:in 1st day,intravenenous injection of 130 mg/m2 Oxaliplatin for 2 hours;oral administration of 1000mg/m2 Capecitabine twice a day for 14 days,repeated every 3 weeks,a total of 4 cycles.(2)In the SOX arm: in 1st day,intravenenous injection of 130 mg/m2 Oxaliplatin for 2 hours;oral administration of 40mg(body surface area <1.25m2),50mg(body surface area of 1.25~1.5m2),60mg(body surface area> 1.5m2)twice a day for 14 days,repeated every 3 weeks,a total of 4 cycles.3.Observed indicator: The treatment-related adverse reactions were assessed in accordance with WHO chemotherapy side effects standard,which divided into 0 ~ ? grade.The efficacy,progression-free survival(PFS),overall survival(OS),adverse reactions and quality of life were observed in both arms.Finally,SPSS17.0 was used for statistical analysis.The data were expressed by((?)±s),and the t-test and count data were used.The data were expressed by Chi-Square.Survival analysis was performed by Kaplan-Meier survival curve.Log-Rank test was used to analyze the survival of the two arms.P <0.05 was considered statistically significant.Results :1.53 patients could evaluate the efficacy in the SOX arm.There were 5 cases with complete response(9.43%),29 cases with partial response(54.72%),15 cases with stable disease(28.30%)and 4 cases with progressive disease(7.55%).Corresponding,53 patients in the Xelox arm.There were 6 cases with complete response(11.32%),31 cases with partial response(58.49%),12 cases with stable disease(22.64%)and 4 cases with progressive disease(7.55%).Then the response rate was 64.15% in the SOX arm vs.69.81% in the Xelox arm(P = 0.536).2.The median PFS of the Xelox arm was 6.6 months(2.5~12.2 months),Corresponding,the median PFS of the SOX arm was 5.7 months(2.0~12.1 months),The median PFS in the Xelox arm was longer than that in the SOX arm,but the difference was not statistically significant(P = 0.472).The median OS of the Xelox arm was 12.5 months and 11.6 months in the SOX arm.The difference was not statistically significant(P = 0.767).3.Quality of life assessment: Of the 53 patients in the Xelox arm,26 were improved(49.06%),11 were stable(20.75%),16 were decreased(30.19%)and 37 cases of total improvement in quality of life(69.81%).In the SOX arm:improved quality of life in 29 cases(73.58%),quality of life was stable in 10 cases(18.87%),decreased in 14 cases and 39 cases of total improvement in quality of life(73.58%).The quality of life was improved in both arms after treatment,but there was no significant difference between the two arms(P=0.666).4.Safety evaluation: two groups of patients were ?/ grade adverse reactions,?well safety and tolerated.The incidence of hand-foot syndrome in XELOX group was significantly higher than that in SOX group(P = 0.037).Conclusion:1.Oxaliplatin combined with Capecitabine or S-1 has similar treatment efficacy in the treatment of postoperative recurrence and metastasis of gastric cancer, the improvement in the quality of life of patients is comparable.2.The incidence of hand-foot syndrome in XELOX arm was significantly higher than that in SOX arm,and there was no difference in the safety of the two regimens.