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Comparison of Docetaxel + Oxaliplatin + S-1 vs Oxalipatin + S-1 as Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer: A Propensity Score Matched Analysis

Authors Zhang X, Huang H, Wei Z, Zhu Z, Yang D, Fu H, Xu J, Hu Z, Zhang Y, You Q, Huang X, Yan R, Wang W, Cai Q

Received 15 April 2020

Accepted for publication 3 July 2020

Published 30 July 2020 Volume 2020:12 Pages 6641—6653


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Yong Teng

Xin Zhang,1,* Hejing Huang,2,* Ziran Wei,1,* Zhenxin Zhu,1 Dejun Yang,1 Hongbing Fu,1 Jiapeng Xu,1 Zunqi Hu,1 Yu Zhang,1 Qing You,1 Xin Huang,1 Ronglin Yan,1 Weimin Wang,1 Qingping Cai1

1Department of Gastrointestinal Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, People’s Republic of China; 2Department of Ultrasound, Changzheng Hospital, Second Military Medical University, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Qingping Cai; Ronglin Yan Tel +86-21-81885601
; +86-21-81885603
Fax +86-21-81886000

Background: What is the optimal neoadjuvant chemotherapy (NAC) regimen for locally advanced gastric cancer (LAGC) remains debatable. The objective of this study was to compare the efficacy of docetaxel+oxaliplatin+S-1 (DOS) vs oxaliplatin+S-1 (SOX) as NAC for LAGC.
Methods: Data of 248 LAGC patients who received either DOS or SOX as NAC in our hospital between January 2010 and January 2018 were reviewed retrospectively. Propensity score matched (PSM) analysis was applied to minimize the selection bias in both groups. Prognostic factors were screened by univariate and multivariate Cox regression analyses.
Results: Of the 248 LAGC patients included, 180 patients were subjected to the PSM analysis. Patients in DOS group showed a better tumor response to NAC, higher radical resection rate and R0 resection rate than those in SOX group. The overall survival (OS) rate in DOS group was better than that in SOX group, although the overall incidence of Grade 3/4 NAC-related toxicity in DOS group was higher, as represented by leukopenia and neutropenia. Multivariate analysis revealed that the NAC regimen, cTNM stage and the R0 resection rate were independent prognostic factors. In addition, patients with TLND less than 16 population showed a worse OS rate. Subgroup analysis indicated that patients benefited from the addition of docetaxel regardless of the clinical T stage, but those with high clinical N stages (N2-3) did not.
Conclusion: DOS is a safe and feasible NAC regimen for LAGC, which is worth popularizing in clinical practice.

Keywords: locally advanced gastric cancer, neoadjuvant chemotherapy, radical gastrectomy, propensity score matched analysis, docetaxel

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