Abstract
Objective To investigate the correlation between the degree of chemotherapy-induced neutropenia (CIN) caused by the first line DCF scheme and the curative effect and survival in patients with advanced gastric cancer. Methods Clinical data about 110 patients diagnosed with advanced gastric cancer from 2007 to 2012 in our hospital who underwent first-line chemotherapy of DCF regimen at least 2 cycles were retrospectively analyzed. According to the CTCAE 4, CIN was divided into: G0, G1/2, G3, G4 group. The association between CIN and chemotherapy curative effect and prognosis was assessed. Results The multivariate analysis showed that compared with G0 group, the hazard ratio of disease-progression was decreased by 48% (HR=0.52, 95% CI: 0.44 - 0.69, P=0.005) in G1/2 group, 31% (HR=0.69, 95% CI: 0.37 - 0.89, P=0.001) in G3 group and 25% (HR=0.75, 95% CI: 0.46 - 0.98, P=0.023) in G4 group. Similarly, the hazard ratio of death was decreased by 41% (HR=0.59, 95% CI: 0.49 - 0.72, P=0.001) in G1/2 group in comparison with G0 group, 29% (HR=0.71, 95% CI: 0.52 - 0.90, P=0.000) in G3 group, and 26% (HR=0.74, 95% CI: 0.46 - 0.93, P=0.009) in G4 group. The ORR value of G0, G1/2, G3, G4 group were 13.3%, 53.7%, 45.5%, 10.5%, respectively; The DCR value of G0, G1/2, G3, G4 group were 33.3%, 75.9%, 68.2%, 57.9%, respectively. Both ORR and DCR value of the four groups showed significantly statistical differences with the best efficacy showed in G1/2 group. Conclusion Patients who experience G1/2 CIN have a more favorable treatment response and prognosis, however, absence of CIN represents poor efficacy and survival, which suggests that patients in G0 group may not achieve the best effective dose. In addition, G4 CIN does not show better efficacy and prognosis. Therefore, monitoring of CIN is conducive to the early evaluation of curative effect and prognosis, and it is helpful in adjusting the dosage of chemotherapy drugs.
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