Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2024; 16(10): 3224-3238
Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3224
Comparison of efficacy and safety of nab-paclitaxel and oxaliplatin + S-1 and standard S-1 and oxaliplatin chemotherapy regimens for treatment of gastric cancer
Yi-Cong Wang, Long Feng, Gong-Ping Wang, Peng-Jie Yu, Can Guo, Bao-Jia Cai, Yan Song, Ting Pan, Bo-Hao Lin, Yuan-Dong Li, Jing-Jing Xiao
Yi-Cong Wang, Can Guo, Yan Song, Ting Pan, Yuan-Dong Li, Jing-Jing Xiao, Department of Gastrointestinal Oncology, The Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Long Feng, Department of Interventional Medicine, Xi’an No. 3 Hospital, The Affiliated Hospital of Northwestern University, Xi’an 710018, Shaanxi Province, China
Gong-Ping Wang, Bo-Hao Lin, Department of RadiologyLuoyang No. 6 People's Hospital, Luoyang 471000, Henan Province, China
Peng-Jie Yu, Bao-Jia Cai, Department of Gastrointestinal Surgery, The Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Co-first authors: Yi-Cong Wang and Long Feng.
Co-corresponding authors: Gong-Ping Wang and Peng-Jie Yu.
Author contributions: Wang YC, Feng L, Wang GP designed the study and drafted the manuscript; Wang YC, Feng L, Wang GP, Guo C, Cai BJ, Song Y, Pan T, Lin BH, Li YD, Xiao JJ, and Yu PJ interpreted the data and prepared figures and table; Yu PJ designed and organized the study, interpreted the data and revised the manuscript. All authors read and approved the final manuscript.
Supported by The Department of Science and Technology of Qinghai Province, No. 2018-SF-113; and "Kunlun Talents-Plateau Famous Doctors" Project in Qinghai Province.
Institutional review board statement: The trial adhered to the Declaration of Helsinki and gained the approval of Review Committee of the Affiliated Hospital of Qinghai University ("Kunlun Talents-Plateau Famous Doctors" project in Qinghai Province) and it was also approved by the Clinical Medical Research Center of Qinghai Province, and all enrolled patients were given written informed consent (P-SL-2022-035).
Informed consent statement: All patients sign the informed consent form, and I will provide the main version of the informed consent form later.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: This article is willing to jointly promote the development of gastrointestinal surgery with the journal, while complying with all the regulations of the journal.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng-Jie Yu, Doctor, DPhil, PhD, Deputy Director, Research Fellow, Surgeon, Department of Gastrointestinal Surgery, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining 810000, Qinghai Province, China. hnypj768@126.com
Received: July 1, 2024
Revised: August 12, 2024
Accepted: September 2, 2024
Published online: October 27, 2024
Processing time: 88 Days and 9 Hours
Abstract
BACKGROUND

Gastric cancer (GC) is a relatively frequent clinical phenomenon, referring to malignant tumors emerging in the gastric mucosal epithelial cells. It has a high morbidity and mortality rate, posing a significant threat to the health of patients. Hence, how to diagnose and treat GC has become a heated topic in this research field.

AIM

To discuss the effectiveness and safety of nab-paclitaxel in combination with oxaliplatin and S-1 (P-SOX) for the treatment of GC, and to analyze the factors that may influence its outcomes.

METHODS

A total of 219 eligible patients with advanced GC, who were treated at Qinghai University Affiliated Hospital Gastrointestinal Oncology between January 2018 and March 2020, were included in the study. Among them, 149 patients received SOX regimen and 70 patients received S-1 regimen. All patients underwent both preoperative and postoperative chemotherapy consisting of 2-4 cycles each, totaling 6-8 cycles, along with parallel D2 radical surgical treatment. The patients were followed up for a period of three years or until reaching the event endpoint.

RESULTS

The short-term and long-term efficacy of the P-SOX group was significantly higher than that of the SOX group, and the safety was manageable. Cox multivariate analysis revealed that progression-free survival was associated with perioperative chemotherapy efficacy, tumor diameter ≤ 2cm, high differentiation, and early cTNM (T stands for invasion depth; N stands for node metastasis; M stands for distant invasion) stage.

CONCLUSION

In comparison to the SOX regimen, the P-SOX regimen demonstrates improved short-term and long-term efficacy with tolerable adverse reactions. It is anticipated that the P-SOX regimen will emerge as a first-line chemotherapy option for GC. Patients with GC who receive effective perioperative chemotherapy (Response Evaluation Criteria in Solid Tumors 1.1, Tumor Regression Grade), have a tumor diameter ≤ 2cm, exhibit high degree of differentiation, and are at an early cTNM stage show better prognosis.

Keywords: Nab-paclitaxel; Gastric cancer; Efficacy; Safety

Core Tip: NaB-paclitaxel combined with oxaliplatin + S-1 (P-SOX) regimen is superior to conventional SOX regimen in the treatment of gastric cancer. Progression-free survival was associated with effective perioperative chemotherapy (Response Evaluation Criteria in Solid Tumors 1.1, Tumor Regression Grade), tumor diameter ≤ 2 cm, high differentiation, and early cTNM staging.