Yu Yuanyuan, Zhang Zicheng, Meng Qianhao, Wang Ke, Li Qingwei, Ma Yue, Yao Yuanfei, Sun Jie, Wang Guangyu
Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China.
School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, China.
J Gastric Cancer. 2022 Apr;22(2):107-119. doi: 10.5230/jgc.2022.22.e11.
We aimed to explore whether the prognosis of patients treated with capecitabine and oxaliplatin (XELOX) or S-1 and oxaliplatin (SOX) regimens who received fewer cycles of chemotherapy after D2 radical resection for gastric cancer (GC) would be non-inferior to that of patients who received the standard number of cycles of chemotherapy.
Data on patients who received XELOX or SOX chemotherapy after undergoing D2 radical resection at Harbin Medical University Cancer Hospital between January 2011 and May 2016 were collected.
In patients who received 4, 6, and 8 cycles of chemotherapy, the 5-year overall survival (OS) rates were 59.4%, 64.8%, and 62.7%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (hazard ratio [HR], 0.882; 95% confidence interval [CI], 0.599-1.299; P=0.52) or 8 cycles (HR, 0.882; 95% CI, 0.533-1.458; P=0.62) of chemotherapy did not exhibit significantly prolonged OS. The 3-year disease-free survival (DFS) rate of patients who received 4, 6, and 8 cycles of chemotherapy was 62.1%, 67.2%, and 60.8%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (HR, 0.835; 95% CI, 0.572-1.221; P=0.35) or 8 cycles (HR, 0.972; 95% CI, 0.606-1.558; P=0.91) of chemotherapy did not show significantly prolonged DFS. However, the 3-year DFS and 5-year OS rates of patients who received 6 cycles of chemotherapy appeared to be superior to those of patients who received 4 and 8 cycles of chemotherapy.
For patients with stage III GC, 4 to 6 cycles of XELOX or SOX chemotherapy may be a favorable option. This study provides a rationale for further randomized clinical trials.
我们旨在探讨接受胃癌（GC）D2根治性切除术后接受较少周期化疗的卡培他滨联合奥沙利铂（XELOX）或S-1联合奥沙利铂（SOX）方案治疗的患者的预后是否不劣于接受标准化疗周期数的患者。
收集2011年1月至2016年5月在哈尔滨医科大学附属肿瘤医院接受D2根治性切除术后接受XELOX或SOX化疗的患者的数据。
接受4、6和8周期化疗的患者的5年总生存率（OS）分别为59.4%、64.8%和62.7%。与接受4周期化疗的患者相比，接受6周期（风险比[HR]，0.882；95%置信区间[CI]，0.599-1.299；P=0.52）或8周期（HR，0.882；95%CI，0.533-1.458；P=0.62）化疗的患者的OS并未显著延长。接受4、6和8周期化疗的患者的3年无病生存率（DFS）分别为62.1%、67.2%和60.8%。与接受4周期化疗的患者相比，接受6周期（HR，0.835；95%CI，0.572-1.221；P=0.35）或8周期（HR，0.972；95%CI，0.606-1.558；P=0.91）化疗的患者的DFS并未显著延长。然而，接受6周期化疗的患者的3年DFS和5年OS率似乎优于接受4周期和8周期化疗的患者。
对于III期GC患者，4至6周期的XELOX或SOX化疗可能是一个有利的选择。本研究为进一步的随机临床试验提供了理论依据。
