The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310001, China.
Sci Rep. 2024 Jul 2;14(1):15150. doi: 10.1038/s41598-024-65724-8.
Adjuvant oxaliplatin plus S-1 (SOX) chemotherapy for gastric cancer (GC) after D2 gastrectomy has been proven effective. There has yet to be a study that evaluates adjuvant nanoparticle albumin-bound paclitaxel (nab-paclitaxel) plus S-1. In this single-center, retrospective study, GC patients after D2 gastrectomy received either nab-paclitaxel plus S-1 (AS group) or SOX group were recruited between January 2018 and December 2020 in The First Affiliated Hospital of Zhejiang University. Intravenous nab-paclitaxel 120 mg/m or 260 mg/m and oxaliplatin 130 mg/m were administered as eight 3 week cycle, especially in the AS and SOX group. Patients received S-1 twice daily with a dose of 40 mg/m in the two groups on days 1-14 of each cycle. The end points were disease-free survival (DFS) rate at 3 years and adverse events (AEs). There were 56 eligible patients, 28 in the AS group and 35 in the SOX group. The 3 year DFS rate was 78.0% in AS group versus 70.7% in SOX group (p = 0.46). Subgroup analysis showed that the patients with signet-ring positive in the AS group had a prolonged DFS compared with the SOX group (40.0 vs. 13.8 m, p = 0.02). The diffuse-type GC or low differentiation in the AS group was associated with numerically prolonged DFS compared with the SOX group, but the association was not statistically significant (p = 0.27 and p = 0.15 especially). Leukopenia (14.3%) were the most prevalent AEs in the AS group, while thrombocytopenia (28.5%) in the SOX group. Neutropenia (7.1% in AS group) and thrombocytopenia (22.8% in SOX group) were the most common grade 3 or 4 AEs. In this study analyzing past data, a tendency towards a greater 3 year DFS was observed when using AS regimen in signet-ring positive patients. AS group had fewer thrombocytopenia compared to SOX group. More studies should be conducted with larger sample sizes.
奥沙利铂联合 S-1（SOX）辅助化疗已被证实对胃癌（GC）患者行 D2 胃切除术后有效。目前还没有研究评估白蛋白结合型紫杉醇纳米粒（nab-紫杉醇）联合 S-1 的辅助作用。在这项单中心、回顾性研究中，2018 年 1 月至 2020 年 12 月，在浙江大学第一附属医院，对接受 D2 胃切除术的 GC 患者分别采用 nab-紫杉醇联合 S-1（AS 组）或 SOX 组进行治疗。在 AS 和 SOX 组中，每周静脉注射 nab-紫杉醇 120mg/m 或 260mg/m 及奥沙利铂 130mg/m，共 8 个周期。两组患者在每个周期的第 1-14 天，每天接受两次 S-1，剂量为 40mg/m。终点为 3 年无病生存率（DFS）和不良事件（AE）。共有 56 例符合条件的患者，AS 组 28 例，SOX 组 35 例。AS 组的 3 年 DFS 率为 78.0%，SOX 组为 70.7%（p=0.46）。亚组分析显示，AS 组中阳性印戒细胞的患者 DFS 延长，与 SOX 组相比（40.0 比 13.8m，p=0.02）。AS 组弥漫型 GC 或低分化与 SOX 组相比，DFS 有延长趋势，但无统计学意义（p=0.27 和 p=0.15）。AS 组最常见的 AE 为白细胞减少（14.3%），SOX 组为血小板减少（28.5%）。中性粒细胞减少（AS 组 7.1%）和血小板减少（SOX 组 22.8%）是最常见的 3 级或 4 级 AE。在这项分析既往数据的研究中，在阳性印戒细胞患者中使用 AS 方案观察到 3 年 DFS 有增加的趋势。与 SOX 组相比，AS 组的血小板减少发生率较低。应进行更多具有更大样本量的研究。
