Prognosis of Adjuvant SOX vs XELOX Chemotherapy for Gastric Cancer After D2 Gastrectomy in Chinese Patients

Shan Yu; Yan Wang; Xi Cheng; Minzhi Lv; Yuehong Cui; Wei Li; Yiyi Yu; Qian Li; Tianshu Liu

doi:10.2147/CMAR.S270387

Prognosis of Adjuvant SOX vs XELOX Chemotherapy for Gastric Cancer After D2 Gastrectomy in Chinese Patients

Cancer Manag Res. 2020 Oct 13:12:10091-10101. doi: 10.2147/CMAR.S270387. eCollection 2020.

Authors

Shan Yu¹, Yan Wang¹, Xi Cheng², Minzhi Lv³, Yuehong Cui¹, Wei Li¹, Yiyi Yu¹, Qian Li¹, Tianshu Liu^{1

4}

Affiliations

¹ Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
² Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, People's Republic of China.
³ Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
⁴ Center of Evidence-Based Medicine, Fudan University, Shanghai, People's Republic of China.

Abstract

Introduction: To compare the prognosis of adjuvant SOX (S-1 and oxaliplatin) vs XELOX (capecitabine and oxaliplatin) chemotherapy in Chinese patients with gastric cancer (GC) after D2 gastrectomy.

Methods: This was a real-world study of patients with GC (stages II-III) who underwent D2 gastrectomy and received adjuvant SOX or XELOX between 01/2010 and 06/2017 in Zhongshan Hospital affiliated to Fudan University. The patients were matched by propensity score matching. The primary and secondary endpoints were disease-free survival (DFS) and overall survival (OS), respectively. Adverse events (AEs) were compared.

Results: A total of 552 patients were included. The median follow-up time was 24.9 months. There were no differences in DFS (median, 44.4 vs 41.2 months; HR=1.17, 95% CI: 0.92-1.48) and OS (median, 61.5 vs 65.3 months; HR=1.01, 95% CI: 0.73-1.39) between the XELOX and SOX groups. Both DFS and OS had no significant differences between SOX and XELOX for all subgroups based on sex (P=0.949, P=0.990), age (P=0.303, P=0.392), Lauren type (P=0.362, P=0.573), type of gastrectomy (P=0.607 P=0.989), and pathological TNM stage (P=0.899, P=0.888). A total of 86 patients in the SOX subgroup (34.2%) experienced AEs, similar to the rate found in the XELOX subgroup (104 patients or 41.4%; P=0.098).

Discussion: The results suggested that adjuvant SOX chemotherapy has similar survival benefits compared to XELOX chemotherapy in Chinese patients with pathological stage II or III GC after D2 gastrectomy.

Keywords: S-1; XELOX; adjuvant chemotherapy; capecitabine; gastrectomy; gastric cancer; oxaliplatin.

Grants and funding

This work was supported by grants from the National Nature Science Foundation of China (Grant No. 81702965) and the Shanghai Committee of Science and Technology, China (Grant No. 17411951400).