Efficacy and safety of real world neoadjuvant chemotherapy for locally advanced gastric cancer
Objective To investigate the efficacy and safety of two-drug/three-drug neoadjuvant chemotherapy (NACT) for patients with locally advanced gastric/gastroesophageal junction adenocarcinoma. Methods A total of 112 patients with locally advanced gastric/gastroesophageal junction adenocarcinoma admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from January 2016 to December 2021 were selected as study objects,and were divided into two-drug group (36 cases) and three-drug group (76 cases) according to the NACT regimen. All patients underwent at least 2 cycles of NACT followed by surgery. The therapeutic effect,disease-free survival (DFS) and overall survival (OS) were compared between two groups. Results The proportion of partial response in three-drug group was significantly higher than that in two-drug group (P<0.05). There were no significant differences in OS,DFS,R0 resection rate and tumor degradation between two-drug and three-drug groups (P>0.05). Multivariate Cox regression analysis showed that surgical method,pathological differentiation type,pathological stage of postoperative tumor,and nerve invasion were independent risk factors for OS (P<0.05),age,surgical method and pathological stage of postoperative tumor were independent risk factors for DFS (P<0.05). The proportion of severe anemia in three-drug group was significantly higher than that in two-drug group (P<0.05),and there were no significant differences in other adverse reactions between two groups (P>0.05). Conclusion The two-drug/three-drug NACT regimen have no significant effect on the long-term prognosis of patients,but the patient's age,pathological stage of postoperative tumor and pathological differentiation type have certain effects on the prognosis of patients.
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