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Outcomes of 596 Advanced Gastric Cancer Patients with Different Numbers of Chemotherapy Lines: The More Chemotherapy Lines, the Better Survival

Authors Sun L, Wang H, Liu Z, Meng Y, Qiu M, Ju Y, Zhang S

Received 10 August 2020

Accepted for publication 24 September 2020

Published 27 October 2020 Volume 2020:12 Pages 10631—10638


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Bilikere Dwarakanath

Li Sun,1,* Huijun Wang,1,* Zhen Liu,1 Ying Meng,1 Meiqing Qiu,2 Yafei Ju,1 Shu Zhang1

1Department of Gastroenterology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People’s Republic of China; 2Department of Oncology, Zaozhuang Municipal Hospital, Zaozhuang, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Shu Zhang
Department of Gastroenterology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People’s Republic of China
Tel/Fax +86-0531-67626836
Email [email protected]

Objective: Many large-sample prospective randomized clinical trials investigating advanced gastric cancer (AGC) have confirmed the survival advantages of first-line, second-line, or third-line chemotherapy compared with their respective control groups. However, due to the ethical concerns of prospective clinical trials, it is impossible to conduct a randomized comparative study of patients who do not receive chemotherapy and those who receive a second-line or above chemotherapy. Few research reports have addressed the relationship between the number of chemotherapy lines and overall survival (OS) in patients with AGC. In the present study, we analyzed the impact of the number of chemotherapy lines on OS in AGC patients using real-world data.
Patients and Methods: This study collected the medical records of patients with AGC diagnosed at Shandong Cancer Hospital from December 2007 to December 2017. According to the treatment received, AGC patients were divided into groups that did not receive chemotherapy, those who received only 1 line, 2 lines, or 3 lines and above. Kaplan–Meier analysis was used to assess patient survival.
Results: A total of 596 AGC patients were included in this study. The following patients were enrolled: 0 lines (did not receive chemotherapy), 77 (12.9%); 1 line, 235 (39.4%) patients; 2 lines, 185 (31.1%) patients; and ≥ 3 lines 99 (16.6%) patients. OS was significantly correlated with the number of chemotherapy lines (P< 0.001), with a median OS from diagnosis of 3.3, 8.6, 15.6, and 21.0 months for patients receiving 0, 1, 2, ≥ 3 lines of chemotherapy, respectively.
Conclusion: This study showed that the more chemotherapy lines AGC patients received, the longer the OS. This study not only confirmed the impact of chemotherapy lines on OS but it also supplements the results of prospective clinical trials that cannot be completed due to the ethical implications.

Keywords: advanced gastric cancer, number of chemotherapy lines, overall survival, real world data

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