Retrospective Comparison of Capecitabine plus Oxaliplatin and Docetaxel plus S-1 as Adjuvant Chemotherapy for Pathological Stage III Gastric Cancer.

INTRODUCTION

Adjuvant chemotherapy following surgical resection is the standard treatment for patients with pathological stage III (pStage III) gastric cancer (GC) in Japan. Capecitabine plus oxaliplatin (CapeOX) and docetaxel plus S-1 (DS) are recommended adjuvant regimens for this disease; however, no studies have compared the treatment outcomes of the two regimens. Therefore, this study aimed to evaluate the safety and efficacy of CapeOX versus DS as adjuvant chemotherapy in patients with pStage III GC.

METHODS

We retrospectively reviewed the clinical information and treatment outcomes (including relapse-free survival [RFS] and adverse events) of patients with pStage III GC who received either CapeOX or DS as adjuvant chemotherapy at our institution from February 2016 to May 2022.

RESULTS

A total of 73 patients (CapeOX, 31; DS 42) were included in this study. There was no significant difference in RFS between the two groups (3-year RFS: 37% in the CapeOX group vs. 44% in the DS group; hazard ratio [HR] = 1.30 [95% CI: 0.71-2.37], p = 0.400). In the multivariable analysis for RFS, treatment regimen was not identified as a prognostic factor for RFS (HR = 1.02, 95% CI: 0.49-2.09, p = 0.957). Compared with DS, CapeOX was associated with lower incidences of any-grade oral mucositis (10% vs. 50%, p < 0.001) and any-grade alopecia (6% vs. 74%, p < 0.001) and a higher incidence of any-grade peripheral sensory neuropathy (81% vs. 24%, p < 0.001).

CONCLUSION

This analysis suggests that CapeOX and DS offer comparable efficacy as adjuvant chemotherapy for pStage III GC in terms of RFS, while exhibiting distinct adverse event profiles.