BACKGROUND: Surgery combined with postoperative chemotherapy is an effective method for treating patients with gastric cancer (GC) in Asia. The important roles of systemic inflammatory response in chemotherapy have been gradually verified. The purpose of this study was to assess the difference in clinical effectiveness of FOLFOX (oxaliplatin + leucovorin + 5-fluorouracil) and XELOX (oxaliplatin + capecitabine), and the prognostic value of postoperative platelet-lymphocyte ratio (PLR) in the XELOX group. METHODS: Patients who received radical gastrectomy combined with postoperative chemotherapy between 2004 and 2014 were consecutively selected into the FOLFOX and XELOX groups. Group bias was reduced through propensity score matching, which resulted in 278 patients in each group. Cut-off values of systemic immune inflammation (SII) score and PLR were obtained by receiver operating characteristic curve. Kaplan-Meier and Log-rank tests were used to analyze overall survival. The chi-square test was used to analyze the association between clinical characteristics and inflammatory indexes. Univariate and multivariate analyses based on Cox regression analysis showed independent risk factors for prognosis. The nomogram was made by R studio. RESULTS: Patients receiving XELOX postoperative chemotherapy had better survival than those receiving FOLFOX (P < 0.001), especially for stage III GC (P = 0.002). Preoperative SII was an independent risk factor for prognosis in the FOLFOX group, and PLR of the second postoperative chemotherapy regimen in the XELOX group, combined with tumor size and pTNM stage, could construct a nomogram for evaluating recurrence and prognosis. CONCLUSION: XELOX is better than FOLFOX for treatment of GC in Chinese patients, and a nomogram constructed by PLR, tumor size and pTNM stage can predict recurrence and prognosis.
BACKGROUND: Surgery combined with postoperative chemotherapy is an effective method for treating patients with gastric cancer (GC) in Asia. The important roles of systemic inflammatory response in chemotherapy have been gradually verified. The purpose of this study was to assess the difference in clinical effectiveness of FOLFOX (oxaliplatin + leucovorin + 5-fluorouracil) and XELOX (oxaliplatin + capecitabine), and the prognostic value of postoperative platelet-lymphocyte ratio (PLR) in the XELOX group. METHODS: Patients who received radical gastrectomy combined with postoperative chemotherapy between 2004 and 2014 were consecutively selected into the FOLFOX and XELOX groups. Group bias was reduced through propensity score matching, which resulted in 278 patients in each group. Cut-off values of systemic immune inflammation (SII) score and PLR were obtained by receiver operating characteristic curve. Kaplan-Meier and Log-rank tests were used to analyze overall survival. The chi-square test was used to analyze the association between clinical characteristics and inflammatory indexes. Univariate and multivariate analyses based on Cox regression analysis showed independent risk factors for prognosis. The nomogram was made by R studio. RESULTS: Patients receiving XELOX postoperative chemotherapy had better survival than those receiving FOLFOX (P < 0.001), especially for stage III GC (P = 0.002). Preoperative SII was an independent risk factor for prognosis in the FOLFOX group, and PLR of the second postoperative chemotherapy regimen in the XELOX group, combined with tumor size and pTNM stage, could construct a nomogram for evaluating recurrence and prognosis. CONCLUSION: XELOX is better than FOLFOX for treatment of GC in Chinese patients, and a nomogram constructed by PLR, tumor size and pTNM stage can predict recurrence and prognosis.
Authors: Duo Zhang; Jian Zhou; Di Tang; Lin Zhou; Liang Chou; Kuang-Yen Chou; Lei Tao; Li-Ming Lu Journal: Clin Immunol Date: 2016-11-19 Impact factor: 3.969
Authors: Ranjana Advani; Ian Flinn; Leslie Popplewell; Andres Forero; Nancy L Bartlett; Nilanjan Ghosh; Justin Kline; Mark Roschewski; Ann LaCasce; Graham P Collins; Thu Tran; Judith Lynn; James Y Chen; Jens-Peter Volkmer; Balaji Agoram; Jie Huang; Ravindra Majeti; Irving L Weissman; Chris H Takimoto; Mark P Chao; Sonali M Smith Journal: N Engl J Med Date: 2018-11-01 Impact factor: 91.245
Authors: I D Nagtegaal; C A Marijnen; E K Kranenbarg; A Mulder-Stapel; J Hermans; C J van de Velde; J H van Krieken Journal: BMC Cancer Date: 2001-07-16 Impact factor: 4.430
Authors: Suee Lee; Sung Yong Oh; Sung Hyun Kim; Ji Hyun Lee; Min Chan Kim; Ki Han Kim; Hyo-Jin Kim Journal: BMC Cancer Date: 2013-07-22 Impact factor: 4.430