Doxifluridine versus Tegafur/Gimeracil/Oteracil (S-1) as adjuvant chemotherapy for patients with gastric cancer after gastrectomy: A propensity score-matched analysis.

Abstract

INTRODUCTION:

Doxifluridine (DF), an oral 5-FU prodrug, has been used for various solid cancers due to its efficacy and low toxicity. We aim to evaluate the effect of DF as adjuvant monotherapy in advanced gastric cancer.

METHODS:

We retrospectively reviewed the clinical data of 263 patients with advanced gastric cancer who underwent curative gastrectomy between January 2010 and December 2013 at our institute. Since previous randomized control trials have confirmed the efficacy of S-1 as adjuvant chemotherapy in advanced gastric cancer, we analyzed the oncologic effect and patient compliance of the DF group compared to the S-1 group. After propensity score matching, 48 patients were included in each group.

RESULTS:

There was no significant difference in 5-year overall survival (OS) and 5-year disease-free survival (DFS) between DF and S-1 groups (5-year OS; 77.1% vs 75.0%; p = 0.729, 5-year DFS; 76.6% vs 73.9%; p = 0.748). The completion rates of the DF and S-1 groups were 60.4% and 72.9%, respectively (p = 0.194). The mean relative dose intensity of the DF and S-1 groups were 76.2% and 84.2%, respectively (p = 0.195). After multivariate analysis, the chemotherapy regimen was not a risk factor for OS and DFS, whereas relative dose intensity and pathologic stage were independent prognostic factors.

CONCLUSION:

There was no significant difference in the oncologic effect and patient compliance between DF and S-1 groups. DF could be an alternative option for adjuvant chemotherapy in advanced gastric cancer. In addition, we confirmed that relative dose intensity is an important independent prognostic factor for survival.

• Authors: Ji Yoon Jeong, Sang Hyuk Seo, Kwang Hee Kim, Min Sung An, HyungJoo Baik, Sang Hyun Kang, Sang Hoon Oh
• Journal: Asian journal of surgery (Asian J Surg) Vol. 46 Issue 9 Pg. 3656-3662 (Sep 2023) ISSN: 0219-3108 [Electronic] Netherlands
• PMID: 37002050 (Publication Type: Journal Article)
• Copyright: Copyright © 2023 Asian Surgical Association and Taiwan Robotic Surgery Association. Published by Elsevier B.V. All rights reserved.

Chemical References

• Tegafur
• doxifluridine
• gimeracil
• Oxonic Acid

Topics

• Humans
• Stomach Neoplasms (surgery)
• Tegafur (adverse effects)
• Retrospective Studies
• Oxonic Acid (adverse effects)
• Propensity Score
• Chemotherapy, Adjuvant (adverse effects)
• Gastrectomy
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Neoplasm Staging