Department of Oncology, Changzhou Tumor Hospital Affiliated to Soochow University, Changzhou, China.
Ann Palliat Med. 2021 Dec;10(12):12821-12830. doi: 10.21037/apm-21-3584.
Dose-limiting neurotoxicity is the major side effect caused by oxaliplatin treatment. Optimization of oxaliplatin-containing chemotherapeutic regimens may potentially benefit advanced gastric cancer (AGC) patients. We tried to reduce the dose of oxaliplatin and add a drug to compensate for the efficacy. This cohort study evaluated the efficacy and side effects of low-dose oxaliplatin combined with pegylated liposomal doxorubicin and S-1 (D-SOX) as first-line treatment for AGC.
64 AGC patients treated in our hospital between January 2015 and December 2018 were included in this study. Among them, 29 cases received standard S-1 and oxaliplatin (SOX) regimen, and 35 cases received D-SOX. Progression-free survival (PFS), overall survival (OS), response rate (RR), and safety were analyzed.
The median PFS was 7.0 months [95% confidence interval (CI): 5.77 to 8.23 months] in the SOX group and 9.3 months (95% CI: 8.145 to 10.45 months) in the D-SOX group (P=0.021). The median OS was 12.5 months (95% CI: 7.00 to 17.97 months) in the SOX group and 18.7 months (95% CI: 14.485 to 22.9 months) in the D-SOX group (P=0.027). The incidence of treatment-related grade III-IV adverse events (AEs) was less than 10%. The RRs to these 2 regimens were similar (P=0.609). The incidence of neurotoxicity was significantly reduced in the D-SOX group (62.8% vs. 82.7%).
Low-dose oxaliplatin combined with S-1 and pegylated liposomal doxorubicin (PLD) regimen improved OS and PFS, while exhibiting better toxicity profile as compared with standard SOX regimen for AGC.
奥沙利铂治疗引起的剂量限制神经毒性是主要的副作用。优化含奥沙利铂的化疗方案可能使晚期胃癌（AGC）患者受益。我们试图减少奥沙利铂的剂量，并添加一种药物来弥补疗效。这项队列研究评估了低剂量奥沙利铂联合聚乙二醇化脂质体阿霉素和 S-1（D-SOX）作为 AGC 一线治疗的疗效和副作用。
本研究纳入 2015 年 1 月至 2018 年 12 月在我院治疗的 64 例 AGC 患者。其中，29 例患者接受标准 S-1 和奥沙利铂（SOX）方案治疗，35 例患者接受 D-SOX 方案治疗。分析无进展生存期（PFS）、总生存期（OS）、客观缓解率（RR）和安全性。
SOX 组的中位 PFS 为 7.0 个月[95%置信区间（CI）：5.77-8.23 个月]，D-SOX 组为 9.3 个月（95%CI：8.145-10.45 个月）（P=0.021）。SOX 组的中位 OS 为 12.5 个月（95%CI：7.00-17.97 个月），D-SOX 组为 18.7 个月（95%CI：14.485-22.9 个月）（P=0.027）。治疗相关 III-IV 级不良事件（AE）的发生率低于 10%。两种方案的 RR 相似（P=0.609）。D-SOX 组神经毒性的发生率明显降低（62.8% vs. 82.7%）。
与标准 SOX 方案相比，低剂量奥沙利铂联合 S-1 和聚乙二醇化脂质体阿霉素（PLD）方案可改善 OS 和 PFS，同时具有更好的毒性特征，可用于治疗 AGC。
