Research Institute of General Surgery, Jinling Hospital, Clinical Medicine School of Nanjing University, 305 East Zhongshan Road, Nanjing 210002, China.
World J Surg Oncol. 2012 Aug 14;10:162. doi: 10.1186/1477-7819-10-162.
The aim of this study was to compare the efficacy of two neoadjuvant chemotherapies (FLEEOX and XELOX) with different routes of administration for unresectable gastric cancer.
A total of 85 patients with unresectable gastric cancer hospitalized from January 2007 to December 2009 received neoadjuvant chemotherapy. The FLEEOX group (48 patients) received the FLEEOX regimen(fluorouracil, leucovorin, http://epirubicin, epotoside, and oxaliplatin), which combined arterial with venous administration for one or two cycles, while the XELOX group (37 patients) received XELOX (capecitabine plus oxaliplatin) via venous administration for two to four cycles. The clinical response and overall survival of the two groups were compared.
In the FLEEOX group, the clinical response rate (RR) of chemotherapy was 85.4% (41 of 48 patients) and the median survival time was 25 months. The 1-year and 2-year disease-free survival (DFS) rates were 85.4% and 45.8%, respectively. In the XELOX group, the clinical RR was 59.5% and the median survival time was 9 months, while the 1-year and 2-year survival rates were 35.2% and 8.3%, respectively. The clinical RR, the R0 resection rate, the median survival time, and the 1-year and 2-year DFS rates were significantly better (P < 0.05) in the FLEEOX group than in the XELOX group. In addition, there were no significant differences in the rates of toxic and adverse reactions or post-operative complications between the two groups.
For patients with a preoperative diagnosis of unresectable gastric cancer, the efficacy of the FLEEOX regimen, which combines arterial with venous administration, was better than that of the XELOX regimen, using venous administration only. This combination of arterial and venous administration could be useful for improving the efficacy of neoadjuvant chemotherapy for gastric cancer.
本研究旨在比较两种新辅助化疗方案（FLEEOX 和 XELOX）在不可切除胃癌中的疗效，这两种方案给药途径不同。
本研究共纳入 2007 年 1 月至 2009 年 12 月期间住院的 85 例不可切除胃癌患者，接受新辅助化疗。FLEEOX 组（48 例）接受 FLEEOX 方案（氟尿嘧啶、亚叶酸钙、表柔比星、依托泊苷、奥沙利铂）治疗，方案联合动脉和静脉给药 1 或 2 个周期；XELOX 组（37 例）接受静脉给药 XELOX（卡培他滨联合奥沙利铂）2 至 4 个周期。比较两组的临床反应和总生存期。
FLEEOX 组化疗的临床缓解率（RR）为 85.4%（41/48 例），中位生存时间为 25 个月。1 年和 2 年无病生存率（DFS）分别为 85.4%和 45.8%。XELOX 组的临床 RR 为 59.5%，中位生存时间为 9 个月，1 年和 2 年生存率分别为 35.2%和 8.3%。FLEEOX 组的临床 RR、R0 切除率、中位生存时间和 1 年及 2 年 DFS 率均显著优于 XELOX 组（P<0.05）。此外，两组间毒性和不良反应或术后并发症发生率无显著差异。
对于术前诊断为不可切除胃癌的患者，联合动脉和静脉给药的 FLEEOX 方案的疗效优于仅静脉给药的 XELOX 方案。这种联合动脉和静脉给药的方法可能有助于提高胃癌新辅助化疗的疗效。
