FLOT vs DOS neoadjuvant chemotherapy in locally advanced gastric cancer: propensity score analysis.

IF 2.8 3区医学 Q3 ONCOLOGY

International Journal of Clinical Oncology Pub Date : 2025-10-07 DOI:10.1007/s10147-025-02888-x

Lu-Yang Zhang, Sen Zhang, Xuan Zhao, Hao Li, Lu Zang, Jun-Jun Ma, Min-Hua Zheng, Abe Fingerhut

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引用次数: 0

Abstract

Background: The safety and efficacy of neoadjuvant FLOT (Fluorouracil, Leucovorin, Oxaliplatin, Docetaxel) and DOS (Docetaxel, Oxaliplatin, S-1) regimens for locally advanced gastric cancer (LAGC) have not been compared.

Methods: Patients with histologically confirmed LAGC (stage ≥ cT3 or cN + , no metastasis) treated between 2017-2021 were retrospectively included and propensity-matched into FLOT (4 cycles, n = 72) and DOS (3 cycles, n = 72) groups. Outcomes included RECIST response, grade 3/4 adverse events, surgical/pathological results, and R0 resection rates, and long-term survival (overall survival [OS] and progression-free survival [PFS]).

Results: RECIST response rates were 41.7% (FLOT) vs. 47.2% (DOS); R0 resection rates were 63.9% vs. 72.2%. No significant differences were observed in operative time, blood loss, hospital stay, histopathological regression (TRG1a: 2.8% vs. 8.3%; TRG1b: 13.9% vs. 16.7%), postoperative morbidity (29.8% vs. 24.5%), or grade 3/4 toxicity (20.8% vs. 13.9%). The 5-year OS rates were 42.7% and 50.4% (p = 0.652), and the PFS rates were 33.7% and 41.4% (p = 0.548) for the FLOT and DOS groups, respectively.

Conclusion: DOS demonstrated no significant but favorable feasibility, safety, and efficacy compared to FLOT in LAGC. Shorter hospital stay with DOS may enhance patient comfort and reduce healthcare burden.

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局部晚期胃癌的FLOT与DOS新辅助化疗：倾向评分分析。

背景：新辅助FLOT（氟尿嘧啶、亚叶酸钙、奥沙利铂、多西紫杉醇）方案和DOS（多西紫杉醇、奥沙利铂、S-1）方案治疗局部晚期胃癌（LAGC）的安全性和有效性尚未比较。方法：回顾性纳入2017-2021年间组织学证实的LAGC（≥cT3期或cN +期，无转移）患者，并将其倾向匹配为FLOT（4个周期，n = 72）和DOS（3个周期，n = 72）组。结果包括RECIST反应、3/4级不良事件、手术/病理结果、R0切除率和长期生存（总生存期[OS]和无进展生存期[PFS]）。结果：RECIST有效率为41.7% (FLOT) vs. 47.2% (DOS)；R0切除率分别为63.9%和72.2%。在手术时间、出血量、住院时间、组织病理退化（TRG1a: 2.8% vs. 8.3%; TRG1b: 13.9% vs. 16.7%）、术后发病率（29.8% vs. 24.5%）或3/4级毒性（20.8% vs. 13.9%）方面均无显著差异。FLOT组和DOS组的5年OS分别为42.7%和50.4% (p = 0.652)， PFS分别为33.7%和41.4% （p = 0.548）。结论：与FLOT相比，DOS在LAGC中的可行性、安全性和有效性不显著，但具有良好的疗效。缩短DOS住院时间可提高患者舒适度，减轻医疗负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Clinical Oncology 医学-肿瘤学

CiteScore

6.80

自引率

3.00%

发文量

175

审稿时长

2 months

期刊介绍： The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.