奥沙利铂与紫杉醇分别联合卡培他滨在局部进展期胃癌新辅助化疗中的疗效与安全性对比研究OA

Objective To compare the short-term efficacy and safety of oxaliplatin plus capecitabine(XELOX)versus paclitaxel plus capecitabine(TX)as neoadjuvant chemotherapy(NAC)for locally advanced gastric cancer(LAGC).Methods A total of 68 patients with LAGC who were treated at the First Affiliated Hospital of Henan Polytechnic University(Jiaozuo Second People's Hospital)between February 2022 and February 2024 were enrolled and randomized by a random number table into a control group and a study group(n=34 each).Both groups received NAC.The control group received the TX regimen,whereas the study group received the XELOX regimen.Tumor regression grade(TRG),tumor marker levels,progression-free survival(PFS),and the incidence of adverse events were compared between the two groups.Results The proportion of patients achieving TRG 1a～1b was significantly higher in the study group than in the control group(P＜0.05).After three chemotherapy cycles,serum carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),and carbohydrate antigen 72-4(CA72-4)levels were lower in the study group than in the control group,with statistically significant differences(P＜0.05).There was no statistically significant difference in PFS between the two groups(P＞0.05).The study group had higher incidences of nausea/vomiting and peripheral neurotoxicity,but lower incidences of alopecia and myelosuppression,than the control group;all differences were statistically significant(P＜0.05).Conclusion In NAC for LAGC,the XELOX regimen yields a higher rate of favorable TRG(lower TRG grade)and is associated with less myelosuppression,but gastrointestinal reactions and peripheral neurotoxicity are more common.The two regimens show no significant difference in PFS.Clinical selection should balance efficacy against the toxicity profile.