Efficacy after preoperative capecitabine and oxaliplatin (XELOX) versus docetaxel, oxaliplatin and S1 (DOS) in patients with locally advanced gastric adenocarcinoma: a propensity score matching analysis

Abstract

[...]71 patients missed follow-up within the first two treatment cycles. [...]the study population included 248 patients, among whom 159 received the XELOX regimen and 89 received the DOS regimen (Fig. 1). Table 3 Surgical findings for the patients received radical surgery after chemotherapy (N = 176) XELOX group (n = 111) DOS group (n = 65) P Pathological response Responders 59 (53.1) 48 (73.8) 0.010 pCR 10 (9.0) 8 (12.9) 0.685 Median total nodes 30 (2–75) 34 (9–71) Median positive nodes 4 (0–62) 2 (0–30) Median time from end of treatment to surgery 29 (16–38) 30 (17–42) Median time from surgery to discharge 11 (6–39) 13 (5–43) Pathological T stage ypT0 13 (11.7) 9 (13.8) 0.623 ypT1 14 (12.6) 7 (10.7) 0.715 ypT2 13 (11.7) 12 (18.5) 0.215 ypT3 35 (31.5) 26 (40.0) 0.254 ypT4 36 (32.5) 11 (17.0) 0.024 Combined ypT0/ypT1/ypT2/ypT3 75 (67.5) 54 (83.0) 0.038 Pathological N stage ypN0 (no regional lymph nodes) 35 (31.5) 26 (40.0) 0.329 ypN1 (1–2 positive lymph nodes) 17 (15.3) 12 (18.5) 0.739 ypN2 (3–6 positive lymph nodes) 23 (20.7) 10 (16.1) 0.499 ypN3 (> 6 positive lymph nodes) 36 (32.5) 17 (28.4) 0.480 Survival After a median follow-up of 18.7 months (range, 2.2–87.3 months), 151 patients (106 in the XELOX group and 45 in the DOS group) experienced disease progression or relapse, and 133 patients (99 in the XELOX group and 34 in the DOS group) had died. Table 4 Grade 3/4 events in the whole population (N = 248) Toxicities XELOX group (N = 159) DOS group (N = 89) P leukocytopenia 6 (3.7) 3 (3.4) 0.848 Febrile neutropenia 1 (0.6) 0 (0) 0.768 thrombocytopenia 5 (3.1) 3 (3.4) 0.781 anemia 2 (1.3) 0 (0) 0.747 nausea 2 (1.3) 1 (1.1) 0.608 vomiting 1 (0.6) 1 (1.1) 0.747 diarrhea 1 (0.6) 0 (0) 0.768 hand-foot skin reaction 3 (1.9) 1 (1.1) 0.945 hepatic dysfunction 2 (1.3) 1 (1.1) 0.608 neuropathy 2 (1.3) 0 (0) 0.747 Mucositis 3 (1.9) 1 (1.1) 0.946 Discussion In this study of preoperative chemotherapy in Chinese patients with locally advanced gastric cancer, we first demonstrated the benefits of the additional use of docetaxel to fluoropyrimidines and oxaliplatin as compared with the XELOX regimen alone. [...]we did not routinely perform laparoscopic exploration for the patients with locally advanced gastric cancer, which is regarded as the most helpful procedure to detect peritoneal dissemination with high sensitivity and specificity.