Clinical Research Papers:
Comparison of efficacy in adjuvant chemotherapy regimens in patients with radically resected gastric cancer: a propensity-matched analysis
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RenCui Quan1,*, JiaXing Huang1,*, HongTao Chen2,*, YiFeng Liao1, WeiZe Lv1, Nan Chen1, JianJun Liu3,4, HongYu Zhang1, DaZhi Xu3,4
1Department of Medical Oncology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhu Hai, Guangdong Province, People’s Republic of China
2Department of Laboratory, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhu Hai, Guangdong Province, People’s Republic of China
3Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China
4State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong Province, China
*These authors have contributed equally to this work
HongYu Zhang, email: [email protected]
DaZhi Xu, email: [email protected]
Keywords: adjuvant chemotherapy, radically resected, gastric cancer
Received: February 20, 2016 Accepted: August 09, 2016 Published: September 01, 2016
Background: We conducted the retrospective study to compare the efficacy of monotherapies versus two-drug regimens as postoperative chemotherapy for patients with radically resected gastric cancer.
Result: At a median follow-up of 5.3 years, no significant difference in terms of OS was observed between two groups, neither before nor after matching. After matching, median DFS was statistically significant between group A and B (median, 67.5 vs 101.0 months, respectively; hazard ratio [HR], 0.65; 95% CI, 0.45 to 0.95; P=0.027), which meant doublets prolonged DFS. In subgroup analysis, the patients of stage III receiving doublet achieved better OS than those receiving monotherapy. People who received doublet and were less than 65 years old, or male patients, or in T4 stage, or in N2 stage, or receiving subtotal gastrectomy had better DFS than those with monotherapy.
Method: A data set including 501 patients (monotherapy, n=107; doublet, n=394) was matched between the two groups (n=107 patients per group) using the propensity-matched study. The primary and secondary endpoint was overall survival(OS) and disease-free survival(DFS), respectively. Survival data was compared using the Kaplan-Meier method and Cox proportion hazards models for univariate and multivariate analyses.
Conclusion: The dual regimens seemed not to add overall survival benefits to patients receiving curative gastrectomy, compared with single-agent fluoropyrimidine as postoperative chemotherapy. However, dual regimens showed better disease-free survival.
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