Adjuvant Capecitabine and Oxaliplatin vs. Capecitabine and Paclitaxel in Gastric Cancer Patients after D2 Gastrectomy

Objective: This retrospective study was carried out to compare the safety and efficacy of adjuvant capecitabine/ oxaliplatin (XELOX) versus capecitabine/paclitaxel (XP) in gastric cancer patients after D2 gastrectomy. Methods: The hospital records of the First Affiliated Hospital of Nanjing Medical University from 2008-2012 were searched to identify patients treated with adjuvant XELOX or XP after D2 gastrectomy and their clinicopathological data were retrieved. Disease-free survival (DFS) and overall survival (OS) were analyzed by Kaplan-Meier method with log-rank test. Results: A total of 144 stage I-III patients who received adjuvant XELOX (n=89) or XP (n=55) after D2 gastrectomy were identified. The median follow-up time was 47.0 (25.0-80.0) months. The 3-year DFS and OS rate was 67.0% versus 50.8% (p=0.047) and 74.8% versus 63.5% (p=0.184) in the XELOX and XP group respectively. XELOX significantly reduced the risk of relapse at three years (HR 0.60, 95% CI 0.36-0.99) but did not reduced the risk of death at the third year (HR 0.66, 95% CI 0.36-1.22) compared with that treated with XP. Conclusions: These results indicate that adjuvant XELOX after D2 gastrectomy has a clinical advantage over XP; however, prospective studies are needed to verify this finding.