Clinical observation of mFOLFOX6 combined with aspirin on advanced gastric cancer following perioperative period of laparoscopic distal subtotal gastrectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SONG Yingjie ¹ ,  QUAN Changyin ¹ , CAO Shenghua ¹ , ZHANG Yuan ¹ , SHAO Xinhong ¹ , WANG Zhaohui ¹ , FAN Tao ²

1. Department of General Surgery, Three Gorges University People’s Hospital, The First People’s Hospital of Yichang, Yichang, Hubei 443000, P. R. China;
2. Department of Tumor Surgery, Three Gorges University People’s Hospital, The First People’s Hospital of Yichang, Yichang, Hubei 443000, P. R. China;

Corresponding author：

QUAN Changyin, Email: quanchangyin@126.com

Keywords：

advanced gastric cancer; laparoscopic distal subtotal gastrectomy; aspirin; mFOLFOX6 regimen; survival

DOI：

10.7507/1007-9424.201708011

Video：

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Objective To evaluate clinical efficacy of mFOLFOX6 combined with aspirin in treatment of advanced gastric cancer following perioperative period of laparoscopic distal subtotal gastrectomy. Methods One hundred and seven patients with advanced gastric cancer were assigned to observation group (57 cases) and control group (50 cases). The patients in the observation group received the mFOLFOX6 chemotherapy and regular intake of aspirin (100 mg/d) and the control group received the mFOLFOX6 chemotherapy alone. The recurrence or metastasis rate, rate of disease progress, toxicity, median survival time, and 3-year survival rate were compared between the observation group and the control group. Results ① There were no significant differences in the gender, age, pathological type, and so on between the observation group and the control group (P>0.05). ② The rates of toxicity such as the white blood cell reduction, granulocyte reduction, thrombocytopenia had no significant differences in these two groups (P>0.05). ③ The follow-up time was 4–45 months with an average 3.5 years, the rate of disease progress was lower (P=0.032), the median survival time was longer (P=0.043), the cumulative 3-year overall survival (P=0.015) and the cumulative 3-year disease-free survival (P=0.037) were better in the observation group as compared with the control group. Conclusion Preliminary results in this study show that mFOLFOX6 regimen combined with low-dose aspirin could significantly improve efficacy of advanced gastric cancer following perioperative period of laparoscopic distal subtotal gastrectomy, reduce rate of disease progress, and improve survival rate without increasing side effects.

Citation： SONG Yingjie, QUAN Changyin, CAO Shenghua, ZHANG Yuan, SHAO Xinhong, WANG Zhaohui, FAN Tao. Clinical observation of mFOLFOX6 combined with aspirin on advanced gastric cancer following perioperative period of laparoscopic distal subtotal gastrectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(2): 166-170. doi: 10.7507/1007-9424.201708011 Copy

1.	陆宏伟, 张亚飞, 吉鸿, 等. 腹腔镜胃癌 D2 根治术治疗进展期胃癌的疗效与安全性. 中国普外基础与临床杂志, 2015, 22(3): 317-321.
2.	余佩武, 罗华星. 腹腔镜胃癌根治术: 未来治疗胃癌的标准手术. 第三军医大学学报, 2013, 35(18): 1889-1892.
3.	蔡逊, 叶家欣, 马丹丹, 等. 完全腹腔镜与腹腔镜辅助胃癌根治术近期临床疗效的对比研究. 中国普外基础与临床杂志, 2016, 23(2): 186-191.
4.	胡建昆, 陈心足. 重视胃癌不同分型分期的治疗和预后. 中国普外基础与临床杂志, 2014, 21(1): 1-6.
5.	徐岩, 孙哲, 王振宁, 等. 胃癌不同部位淋巴结转移率及其临床意义的研究. 中国普外基础与临床杂志, 2012, 19(1): 16-19.
6.	李振凯, 董茂盛. 进展期胃癌新辅助化疗的研究进展. 中国普外基础与临床杂志, 2014, 21(11): 1460-1464.
7.	Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
8.	王维琼. 2016 年中国恶性肿瘤发病和死亡分析. 临床医药文献杂志, 2017, 4(19): 3604.
9.	汪劭婷, 朱朝晖, 李小毅. 胃癌新辅助化疗疗效临床评价方法及进展. 中国普外基础与临床杂志, 2010, 17(2): 200-204.
10.	Ahn HS, Jeong SH, Son YG, et al. Effect of neoadjuvant chemotherapy on postoperative morbidity and mortality in patients with locally advanced gastric cancer. Br J Surg, 2014, 101(12): 1560-1565.
11.	Chung V, Frankel P, Lim D, et al. Phase Ⅰb trial of mFOLFOX6 and everolimus (NSC-733504) in patients with metastatic gastroesophageal adenocarcinoma. Oncology, 2016, 90(6): 307-312.
12.	Wang X, Zhao L, Liu H, et al. A phase Ⅱ study of a modified FOLFOX6 regimen as neoadjuvant chemotherapy for locally advanced gastric cancer. Br J Cancer, 2016, 114(12): 1326-1333.
13.	Yoon HH, Bendell JC, Braiteh FS, et al. Ramucirumab combined with FOLFOX as front-line therapy for advanced esophageal, gastroesophageal junction, or gastric adenocarcinoma: a randomized, double-blind, multicenter Phase Ⅱ trial. Ann Oncol, 2016, 27(12): 2196-2203.
14.	Shah MA, Bang YJ, Lordick F, et al. Effect of fluorouracil, leucovorin, and oxaliplatin with or without onartuzumab in HER2-negative, MET-positive gastroesophageal adenocarcinoma: The MET Gastric Randomized Clinical Trial. JAMA Oncol, 2017, 3(5): 620-627.
15.	张晓瑞. 改良 FOLFOX6 方案在进展期胃癌新辅助治疗中的应用观察. 基层医学论坛, 2016, 20(34): 4903-4904.
16.	侯娟, 崔丽华, 吴志伟, 等. mFOLFOX6 方案治疗老年晚期胃癌的临床疗效. 齐齐哈尔医学院学报, 2016, 37(27): 3381-3383.
17.	Cascinu S, Rosati G, Nasti G,et al. Treatment sequence with either irinotecan/cetuximab followed by FOLFOX-4 or the reverse strategy in metastatic colorectal cancer patients progressing after first-line FOLFIRI/bevacizumab: An Italian Group for the Study of Gastrointestinal Cancer phase Ⅲ, randomised trial comparing two sequences of therapy in colorectal metastatic patients. Eur J Cancer, 2017, 83: 106-115.
18.	Fletcher RH. Review: Aspirin reduces colorectal cancer incidence and mortality in patients at average risk. Ann Intern Med, 2016, 165(4): JC16.
19.	Cao Y, Nishihara R, Wu K, et al. Population-wide impact of long-term use of aspirin and the risk for cancer. JAMA Oncol, 2016, 2(6): 762-769.
20.	Kim YI, Kim SY, Kim JH, et al. Long-Term low-dose aspirin use reduces gastric cancer incidence: A Nationwide Cohort Study. Cancer Res Treat, 2016, 48(2): 798-805.
21.	Sanomura Y, Oka S, Tanaka S, et al. Continued use of low-dose aspirin does not increase the risk of bleeding during or after endoscopic submucosal dissection for early gastric cancer. Gastric Cancer,2014, 17(3): 489-496.
22.	Li H, Cheng J, Mao Y, et al. miR-21 inhibits the effects of cyclooxygenase-2 inhibitor NS398 on apoptosis and invasion in gastric cancer cells. Onco Targets Ther, 2015, 8: 3245-3253.
23.	Huang XZ, Chen Y, Wu J, et al. Aspirin and non-steroidal anti-inflammatory drugs use reduce gastric cancer risk: A dose-response meta-analysis. Oncotarget, 2017, 8(3): 4781-4795.
24.	Chan AT, Arber N, Burn J, et al. Aspirin in the chemoprevention of colorectal neoplasia: an overview. Cancer Prev Res (Phila), 2012, 5(2): 164-178.

1. 陆宏伟, 张亚飞, 吉鸿, 等. 腹腔镜胃癌 D2 根治术治疗进展期胃癌的疗效与安全性. 中国普外基础与临床杂志, 2015, 22(3): 317-321.
2. 余佩武, 罗华星. 腹腔镜胃癌根治术: 未来治疗胃癌的标准手术. 第三军医大学学报, 2013, 35(18): 1889-1892.
3. 蔡逊, 叶家欣, 马丹丹, 等. 完全腹腔镜与腹腔镜辅助胃癌根治术近期临床疗效的对比研究. 中国普外基础与临床杂志, 2016, 23(2): 186-191.
4. 胡建昆, 陈心足. 重视胃癌不同分型分期的治疗和预后. 中国普外基础与临床杂志, 2014, 21(1): 1-6.
5. 徐岩, 孙哲, 王振宁, 等. 胃癌不同部位淋巴结转移率及其临床意义的研究. 中国普外基础与临床杂志, 2012, 19(1): 16-19.
6. 李振凯, 董茂盛. 进展期胃癌新辅助化疗的研究进展. 中国普外基础与临床杂志, 2014, 21(11): 1460-1464.
7. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
8. 王维琼. 2016 年中国恶性肿瘤发病和死亡分析. 临床医药文献杂志, 2017, 4(19): 3604.
9. 汪劭婷, 朱朝晖, 李小毅. 胃癌新辅助化疗疗效临床评价方法及进展. 中国普外基础与临床杂志, 2010, 17(2): 200-204.
10. Ahn HS, Jeong SH, Son YG, et al. Effect of neoadjuvant chemotherapy on postoperative morbidity and mortality in patients with locally advanced gastric cancer. Br J Surg, 2014, 101(12): 1560-1565.
11. Chung V, Frankel P, Lim D, et al. Phase Ⅰb trial of mFOLFOX6 and everolimus (NSC-733504) in patients with metastatic gastroesophageal adenocarcinoma. Oncology, 2016, 90(6): 307-312.
12. Wang X, Zhao L, Liu H, et al. A phase Ⅱ study of a modified FOLFOX6 regimen as neoadjuvant chemotherapy for locally advanced gastric cancer. Br J Cancer, 2016, 114(12): 1326-1333.
13. Yoon HH, Bendell JC, Braiteh FS, et al. Ramucirumab combined with FOLFOX as front-line therapy for advanced esophageal, gastroesophageal junction, or gastric adenocarcinoma: a randomized, double-blind, multicenter Phase Ⅱ trial. Ann Oncol, 2016, 27(12): 2196-2203.
14. Shah MA, Bang YJ, Lordick F, et al. Effect of fluorouracil, leucovorin, and oxaliplatin with or without onartuzumab in HER2-negative, MET-positive gastroesophageal adenocarcinoma: The MET Gastric Randomized Clinical Trial. JAMA Oncol, 2017, 3(5): 620-627.
15. 张晓瑞. 改良 FOLFOX6 方案在进展期胃癌新辅助治疗中的应用观察. 基层医学论坛, 2016, 20(34): 4903-4904.
16. 侯娟, 崔丽华, 吴志伟, 等. mFOLFOX6 方案治疗老年晚期胃癌的临床疗效. 齐齐哈尔医学院学报, 2016, 37(27): 3381-3383.
17. Cascinu S, Rosati G, Nasti G,et al. Treatment sequence with either irinotecan/cetuximab followed by FOLFOX-4 or the reverse strategy in metastatic colorectal cancer patients progressing after first-line FOLFIRI/bevacizumab: An Italian Group for the Study of Gastrointestinal Cancer phase Ⅲ, randomised trial comparing two sequences of therapy in colorectal metastatic patients. Eur J Cancer, 2017, 83: 106-115.
18. Fletcher RH. Review: Aspirin reduces colorectal cancer incidence and mortality in patients at average risk. Ann Intern Med, 2016, 165(4): JC16.
19. Cao Y, Nishihara R, Wu K, et al. Population-wide impact of long-term use of aspirin and the risk for cancer. JAMA Oncol, 2016, 2(6): 762-769.
20. Kim YI, Kim SY, Kim JH, et al. Long-Term low-dose aspirin use reduces gastric cancer incidence: A Nationwide Cohort Study. Cancer Res Treat, 2016, 48(2): 798-805.
21. Sanomura Y, Oka S, Tanaka S, et al. Continued use of low-dose aspirin does not increase the risk of bleeding during or after endoscopic submucosal dissection for early gastric cancer. Gastric Cancer,2014, 17(3): 489-496.
22. Li H, Cheng J, Mao Y, et al. miR-21 inhibits the effects of cyclooxygenase-2 inhibitor NS398 on apoptosis and invasion in gastric cancer cells. Onco Targets Ther, 2015, 8: 3245-3253.
23. Huang XZ, Chen Y, Wu J, et al. Aspirin and non-steroidal anti-inflammatory drugs use reduce gastric cancer risk: A dose-response meta-analysis. Oncotarget, 2017, 8(3): 4781-4795.
24. Chan AT, Arber N, Burn J, et al. Aspirin in the chemoprevention of colorectal neoplasia: an overview. Cancer Prev Res (Phila), 2012, 5(2): 164-178.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical observation of mFOLFOX6 combined with aspirin on advanced gastric cancer following perioperative period of laparoscopic distal subtotal gastrectomy

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