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 Citations (Scopus)

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

Fingerprint

Stomach Neoplasms
Dissection
oxaliplatin
Survival
Propensity Score
Therapeutics
Hand-Foot Syndrome
XELOX
Leucovorin
Solar System
Fluorouracil
Multivariate Analysis
Lymph Nodes
Databases
Neoplasm Metastasis
Drug Therapy
Incidence
Neoplasms

Keywords

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

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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

Efficacy of adjuvant XELOX and FOLFOX6 chemotherapyafter D2 dissection for gastric cancer. / Wu, Ying; Wei, Zhe Wei; He, Yu Long; Schwarz, Roderich E.; Smith, David D.; Xia, Guang Kai; Zhang, Chang Hua.

In: World Journal of Gastroenterology, Vol. 19, No. 21, 07.06.2013, p. 3309-3315.

Research output: Contribution to journalArticle

Wu, Y, Wei, ZW, He, YL, Schwarz, RE, Smith, DD, Xia, GK & Zhang, CH 2013, 'Efficacy of adjuvant XELOX and FOLFOX6 chemotherapyafter D2 dissection for gastric cancer', World Journal of Gastroenterology, vol. 19, no. 21, pp. 3309-3315. https://doi.org/10.3748/wjg.v19.i21.3309
Wu, Ying ; Wei, Zhe Wei ; He, Yu Long ; Schwarz, Roderich E. ; Smith, David D. ; Xia, Guang Kai ; Zhang, Chang Hua. / Efficacy of adjuvant XELOX and FOLFOX6 chemotherapyafter D2 dissection for gastric cancer. In: World Journal of Gastroenterology. 2013 ; Vol. 19, No. 21. pp. 3309-3315.
@article{1b5d3dac4b2b4d8091d87ffd0bd17c50,
title = "Efficacy of adjuvant XELOX and FOLFOX6 chemotherapyafter D2 dissection for gastric cancer",
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.",
keywords = "5-fluorouracil, Adjuvant, Capecitabine and oxaliplatin, D2 dissection, Folinic acid and oxaliplatin, Gastric cancer",
author = "Ying Wu and Wei, {Zhe Wei} and He, {Yu Long} and Schwarz, {Roderich E.} and Smith, {David D.} and Xia, {Guang Kai} and Zhang, {Chang Hua}",
year = "2013",
month = "6",
day = "7",
doi = "10.3748/wjg.v19.i21.3309",
language = "English (US)",
volume = "19",
pages = "3309--3315",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "21",

}

TY - JOUR

T1 - Efficacy of adjuvant XELOX and FOLFOX6 chemotherapyafter D2 dissection for gastric cancer

AU - Wu, Ying

AU - Wei, Zhe Wei

AU - He, Yu Long

AU - Schwarz, Roderich E.

AU - Smith, David D.

AU - Xia, Guang Kai

AU - Zhang, Chang Hua

PY - 2013/6/7

Y1 - 2013/6/7

N2 - 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.

AB - 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.

KW - 5-fluorouracil

KW - Adjuvant

KW - Capecitabine and oxaliplatin

KW - D2 dissection

KW - Folinic acid and oxaliplatin

KW - Gastric cancer

UR - http://www.scopus.com/inward/record.url?scp=84878591707&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878591707&partnerID=8YFLogxK

U2 - 10.3748/wjg.v19.i21.3309

DO - 10.3748/wjg.v19.i21.3309

M3 - Article

VL - 19

SP - 3309

EP - 3315

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 21

ER -