Efficacy of adjuvant XELOX and FOLFOX6 chemotherapyafter D2 dissection for gastric cancer

Ying Wu, Zhe Wei Wei, Yu Long He, Roderich E. Schwarz, David D. Smith, Guang Kai Xia, Chang Hua Zhang

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

AIM: To compare the efficacy of capecitabine and oxaliplatin (XELOX) with 5-fluorouracil, folinic acid and oxaliplatin (FOLFOX6) in gastric cancer patients after D2 dissection. METHODS: Between May 2004 and June 2010, patients in our gastric cancer database who underwent D2 dissection for gastric cancer at the First Affiliated Hospital of Sun Yat-Sen University were retrospectively analyzed. A total of 896 patients were enrolled into this study according to the established inclusion and exclusion criteria. Of these patients, 214 received the XELOX regimen, 48 received FOLFOX6 therapy and 634 patients underwent surgery only without chemotherapy. Overall survival was compared among the three groups using Cox regression and propensity score matchedpair analyses. RESULTS: Patients in the XELOX and FOLFOX6 groups were younger at the time of treatment (median age 55.2 years; 51.2 years vs 58.9 years), had more undifferentiated tumors (70.1%; 70.8% vs 61.4%), and more lymph node metastases (80.8%; 83.3% vs 57.7%), respectively. Overall 5-year survival was 57.3% in the XELOX group which was higher than that (47.5%) in the surgery only group (P = 0.062) and that (34.5%) in the FOLFOX6 group (P = 0.022). Multivariate analysis showed that XELOX therapy was an independent prognostic factor (hazard ratio = 0.564, P < 0.001). After propensity score adjustment, XELOX significantly increased overall 5-year survival compared to surgery only (58.2% vs 44.2%, P = 0.025) but not compared to FOLFOX6 therapy (48.5% vs 42.7%, P = 0.685). The incidence of grade 3/4 adverse reactions was similar between the XELOX and FOLFOX6 groups, and more patients suffered from hand-foot syndrome in the XELOX group (P = 0.018). CONCLUSION: Adjuvant XELOX therapy is associated with better survival in patients after D2 dissection, but does not result in a greater survival benefit compared with FOLFOX6 therapy.

Original languageEnglish (US)
Pages (from-to)3309-3315
Number of pages7
JournalWorld Journal of Gastroenterology
Volume19
Issue number21
DOIs
StatePublished - Jun 7 2013

Keywords

  • 5-fluorouracil
  • Adjuvant
  • Capecitabine and oxaliplatin
  • D2 dissection
  • Folinic acid and oxaliplatin
  • Gastric cancer

ASJC Scopus subject areas

  • Gastroenterology

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    Wu, Y., Wei, Z. W., He, Y. L., Schwarz, R. E., Smith, D. D., Xia, G. K., & Zhang, C. H. (2013). Efficacy of adjuvant XELOX and FOLFOX6 chemotherapyafter D2 dissection for gastric cancer. World Journal of Gastroenterology, 19(21), 3309-3315. https://doi.org/10.3748/wjg.v19.i21.3309