Zhao Qun, Li Yong, Huang Jian, Fan Liqiao, Tan Bibo, Tian Yuan, Yang Peigang, Jiao Zhikai, Zhao Xuefeng, Zhang Zhidong, Wang Dong, Liu Yu
Pharmazie. 2017 Apr 1;72(4):236-240. doi: 10.1691/ph.2017.6865.
This research aimed to investigate the efficacy of S-1 plus oxaliplatin (SOX) as perioperative chemotherapy for locally advanced gastric cancer. We enrolled 102 patients with preoperative clinical stage T3-4N×M0 gastric cancer who were then randomly assigned to receive SOX as either perioperative chemotherapy (group A, 50 patients) or postoperative adjuvant chemotherapy (group B, 52 patients). Short-term curative efficacy and adverse effects of perioperative chemotherapy were analyzed. The rates of R0 resection, surgical complications, combined multiple organ resection, overall survival (OS), and disease-free survival (DFS) were compared between the groups. Results showed an overall response rate in group A of 42%, with a disease control rate of 94% and a tumor down-staging rate of 50%. An R0 resection rate of 90% was achieved in group A, which was significantly higher than that in group B (75%). No surgical mortality was observed, and the differences in surgical complications and combined multiple organ resection rates between the groups were not significant. The postoperative pathological examination of 4 patients in group A did not show any cancer cells in the tumor bed, resulting in a histological complete remission rate of 8%. The average OS and DFS for group A patients were 17.928 and 16.134 months, respectively, which were both longer than that of group B patients. However, the differences were not significant. In all, our results shows that in locally advanced gastric carcinoma, SOX perioperative chemotherapy is effective and results in a significantly improved R0 resection rate compared to postoperative SOX administration. Perioperative SOX does not cause additional surgical complications and has low adverse reaction rates; moreover, it appears to prolong survival.
本研究旨在探讨S-1联合奥沙利铂（SOX）作为局部进展期胃癌围手术期化疗的疗效。我们纳入了102例术前临床分期为T3-4N×M0的胃癌患者，然后将他们随机分为两组，分别接受SOX围手术期化疗（A组，50例患者）或术后辅助化疗（B组，52例患者）。分析围手术期化疗的短期疗效和不良反应。比较两组的R0切除率、手术并发症、联合多器官切除率、总生存期（OS）和无病生存期（DFS）。结果显示，A组的总缓解率为42%，疾病控制率为94%，肿瘤降期率为50%。A组的R0切除率为90%，显著高于B组（75%）。未观察到手术死亡，两组之间手术并发症和联合多器官切除率的差异不显著。A组4例患者的术后病理检查显示肿瘤床无癌细胞，组织学完全缓解率为8%。A组患者的平均OS和DFS分别为17.928个月和16.134个月，均长于B组患者。然而，差异不显著。总之，我们的结果表明，在局部进展期胃癌中，SOX围手术期化疗是有效的，与术后给予SOX相比，R0切除率显著提高。围手术期SOX不会引起额外的手术并发症，不良反应率低；此外，它似乎能延长生存期。
