Adjuvant Capecitabine and Oxaliplatin vs. Capecitabine and Paclitaxel in Gastric Cancer Patients after D2 Gastrectomy

Jing Sun, Shaohua He, P. Lin, Ping Li, Xiaomin Cai, Lele Li, J. Qian, Chong Liu, Xiao Li, Yi-qian Liu, O. Røe, Y. Shu, Yanhong Gu, Xiaofeng Chen
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Abstract

Objective: This retrospective study was carried out to compare the safety and efficacy of adjuvant capecitabine/ oxaliplatin (XELOX) versus capecitabine/paclitaxel (XP) in gastric cancer patients after D2 gastrectomy. Methods: The hospital records of the First Affiliated Hospital of Nanjing Medical University from 2008-2012 were searched to identify patients treated with adjuvant XELOX or XP after D2 gastrectomy and their clinicopathological data were retrieved. Disease-free survival (DFS) and overall survival (OS) were analyzed by Kaplan-Meier method with log-rank test. Results: A total of 144 stage I-III patients who received adjuvant XELOX (n=89) or XP (n=55) after D2 gastrectomy were identified. The median follow-up time was 47.0 (25.0-80.0) months. The 3-year DFS and OS rate was 67.0% versus 50.8% (p=0.047) and 74.8% versus 63.5% (p=0.184) in the XELOX and XP group respectively. XELOX significantly reduced the risk of relapse at three years (HR 0.60, 95% CI 0.36-0.99) but did not reduced the risk of death at the third year (HR 0.66, 95% CI 0.36-1.22) compared with that treated with XP. Conclusions: These results indicate that adjuvant XELOX after D2 gastrectomy has a clinical advantage over XP; however, prospective studies are needed to verify this finding.
胃癌D2胃切除术后辅助卡培他滨和奥沙利铂对比卡培他滨和紫杉醇
目的:本回顾性研究比较D2胃切除术后辅助卡培他滨/奥沙利铂(XELOX)与卡培他滨/紫杉醇(XP)在胃癌患者中的安全性和有效性。方法:检索南京医科大学附属第一医院2008-2012年的住院记录,找出D2胃切除术后辅助使用XELOX或XP的患者,并检索其临床病理资料。采用Kaplan-Meier法和log-rank检验分析无病生存期(DFS)和总生存期(OS)。结果:共有144例I-III期患者在D2胃切除术后接受辅助XELOX (n=89)或XP (n=55)。中位随访时间为47.0(25.0 ~ 80.0)个月。XELOX组和XP组3年DFS和OS分别为67.0%和50.8% (p=0.047)和74.8%和63.5% (p=0.184)。与接受XP治疗的患者相比,XELOX显著降低了三年复发风险(HR 0.60, 95% CI 0.36-0.99),但未降低第三年死亡风险(HR 0.66, 95% CI 0.36-1.22)。结论:D2胃切除术后辅助XELOX较XP有临床优势;然而,需要前瞻性研究来验证这一发现。
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