Efficacy and safety of irinotecan combined with tegafur and paclitaxel combined with tegafur as second-line treatment for advanced gastric cancer

Bulibu Jilisihan; Wang Wei; Saifuding Keyoumu

doi:10.3760/j.issn.1673-4777.2019.09.019

Abstract：Objective To compare the clinical efficacy and safety of irinotecan combined with tegafur and paclitaxel combined with tegafur as second-line treatment for advanced gastric cancer.Methods Eighty patients with advanced gastric cancer who failed in first-line platinum chemotherapy were enrolled in Tumor Hospital Affiliated to Xinjiang Medical University from January 2016 to January 2018.The patients were randomly divided into observation group and control group,with 40 cases in each group.The control group was treated with paclitaxel plus tegafur;the observation group was treated with irinotecan plus tegafur;1 course of chemotherapy lasted for 21 days.One week after 1 course of treatment,occurrences of hepatic and renal dysfunction,neurotoxicity,alopecia and bone marrow suppression were observed.One week after 2 courses of treatment,objective response rate,disease control rate and gastrointestinal adverse reactions were analyzed.Long-term efficacy was observed during 1 year follow-up.Results One week after 1 course of treatment,there was no significant difference in hepatic and renal dysfunction between groups(P ＞ 0.05);neurotoxicity and alopecia were much severer in control group while leukopenia was much sever in observation group(P ＜ 0.05);anemia and thrombocytopenia in observation group were comparable to those in control group(P ＞ 0.05).One week after 2 courses of treatment,occurrences of diarrhea,nausea and vomiting,cholinergic syndrome in observation group were significantly sever than those in control group(all P ＜ 0.05).There were no significant differences of the objective response rate and disease control rate between groups (both P ＞ 0.05).There were no significant differences of the 1-year survival rate,median survival time and median progression-free time between control group and observation group[40.0％ (16/40) vs 42.5％ (17/40),(6.6 ± 1.3) months vs (6.7 ± 1.3) months,(9.4 ± 1.3) months vs (9.3 ± 1.2) months] (all P ＞ 0.05).Conclusions In patients with advanced gastric cancer who failed in first-line platinum-based chemotherapy,irinotecan and paclitaxel combined with tegafur show equal short-term response rate,disease control rate and long-term results.Adverse reactions of irinotecan are mainly myelosuppression,diarrhea and cholinergic syndrome;the main adverse reactions of paclitaxel are neurotoxicity and alopecia.