Clinical Observation Of XELOX And SOX Regimen As First-line Treatment And Sequential Maintenance Chemotherapy For Advanced Gastric Cancer

Objective:To evaluate the efficacy and safety of XELOX regimen compared with SOX regimen as first-line treatment for advanced gastric cancer and sequential Xeloda/S-1 to maintenance Chemotherapy through the retrospective study.Methods: From January 2015 to May 2017,phase IV gastric cancer patients meet the inclusion criteria using XELOX regimen and SOX regimen as first-line chemotherapy were selected from affiliated hospital of Qinghai university and Qinghai provincial people’s hospital.The clinical data were recorded,the therapeutic effect and adverse reactions of each group were observed.Patients who reached the disease control(CR,PR,SD)after first-line chemotherapy continued capecitabine or S-1 to maintenance treatment,or continued observation of the disease.The therapeutic effect and adverse reactions of each maintenance group were observed.The follow-up time was up to February 1,2018.Statistical analysis of effective rate of treatment(RR)、disease control rate(DCR)、adverse reactions、median progression free survival(mPFS)and median overall survival(mOS)for all patients.Results: 1.Clinical efficacy: 63 Patients in XELOX group,achieved RR of 33.3% and DCR of 77.8%;66 Patients in SOX group achieved RR of 34.8% and DCR of 75.8%.There were not differ significantly in RR and DCR between the two groups(P>0.05).99 patients reached the disease control after first-line chemotherapy,21 patients were treated with Capecitabine maintenance,RR was 28.6%,DCR was 66.7%.23 patients were treated with S-1 maintenance,RR was 30.4% and DCR was 69.6%.The curative effect of maintenance treatment are flat in both groups(P>0.05).2.Adverse reaction evaluation: The majority of adverse reactions of XELOX group and SOX group and sequential maintenance treatment is hematology toxicity,gastrointestinal tract reaction,hand-foot syndrome and peripheral nerve dysfunction,most of all adverse reactions isⅠ~Ⅱ degrees,the incidence of Ⅲ~Ⅳ degree is low.Among them,the incidence of hand-foot syndrome in XELOX group and CAP maintenance treatment group is higher than the SOX group and S-1 maintenance treatment group(P<0.05).3.Survival analysis: The mPFS was 5.6 months and the mOS was 11.2 months in observation group after XELOX chemotherapy,the mPFS was 5.2 months and the mOS was 11.3 months in observation group after SOX chemotherapy,there were not differ significantly in PFS and OS among the two groups(P>0.05).The mPFS was 6.8 months and the mOS was 12.4 months in Capecitabine maintenance treatment group,the mPFS was 7.1 months and the mOS was 12.2 months in S-1 maintenance treatment group,there was no significant difference among the two regimens(P>0.05);The mPFS in maintenance treatment group were higher in observation group,the difference in the mPFS was statistically significant(P<0.05),but there was no significant difference in the total survival time(P >0.05).Conclusion: The curative effect of XELOX group was comparable to the SOX group as first-line treatment of AGC.Adverse reactions can be tolerated,the incidence of hand-foot syndrome in XELOX group is higher than the SOX group;The curative effect of Capecitabine group and S-1 group of maintenance treatment is almost equal.There were not differ significantly in the mPFS and the mOS,adverse reactions could also be tolerated,and the incidence of hand-foot syndrome in Capecitabine group is higher than S-1 group.After first-line chemotherapy,sequential fluorouracil drug maintenance treatment can prolong the PFS of patients with AGC,but there is no significant difference in the total survival time.SOX regimen as first-line treatment and sequential S-1 to maintenance Chemotherapy may be a better choice for patients with AGC.