title: Prolonged adjuvant capecitabine chemotherapy improved survival of stage IIIA gastric cancer after D2 gastrectomy.
abstract: OBJECTIVE
  This study aims to investigate the safety and efficacy of prolonged adjuvant capecitabine chemotherapy on survival of gastric cancer after D2 gastrectomy.
  
  
  BACKGROUND
  Inadequate evidence is available on optimal duration of chemotherapy and the number of administered cycles is generally based on patient responsiveness and individual tolerability as well as physician preferences.
  
  
  METHODS
  We randomly assigned 307 gastric cancer patients after D2 gastrectomy between January 2006 and December 2010 to XELOX group and Prolonged group. XELOX consisted of a 2-h intravenous infusion of oxaliplatin 130mg/mg on day 1 and oral capecitabine 1000mg/m(2) twice daily on days 1-14 of a 3-week cycle for eight cycles in half a year. In Prolonged group, patients underwent extra oral capecitabine 1000mg/m(2) twice daily on days 1-14 of a 3-week cycle for eight cycles after eight cycles of XELOX. The disease-free survival and overall survival were compared.
  
  
  RESULTS
  Significant differences were found in 3-year disease-free survival (Prolonged group 56.6%, XELOX group 48.4%, P=0.0357). Subgroup analysis by TNM staging showed that patients with stage IIIA gastric cancer in the Prolonged group had significantly higher DFS (50.00% vs 40.96, P=0.0178) and OS (71.95% vs 57.83, P=0.0230) than that of patients in the XELOX group. No grade 4 adverse effects or treatment-related deaths were reported. More patients in the Prolonged group experienced hand-foot syndrome than in the XELOX group.
  
  
  CONCLUSIONS
  Prolonged capecitabine chemotherapy prevents improves the prognosis of patients with stage IIIA gastric cancer after D2 gastrectomy.
authors.affiliation: Department of General Surgery and Molecular Surgery, First People's Hospital Affiliated to Huzhou University Medical College, Huzhou, Zhejiang Province, China.
authors.forename: Wen Ming
authors.initials: WM
authors.lastname: Feng
authors.affiliation: Department of General Surgery and Molecular Surgery, First People's Hospital Affiliated to Huzhou University Medical College, Huzhou, Zhejiang Province, China. Electronic address: tamgches@sina.com.
authors.forename: Cheng Wu
authors.initials: CW
authors.lastname: Tang
authors.affiliation: Department of General Surgery and Molecular Surgery, First People's Hospital Affiliated to Huzhou University Medical College, Huzhou, Zhejiang Province, China.
authors.forename: Hui Hui
authors.initials: HH
authors.lastname: Guo
authors.affiliation: Department of General Surgery and Molecular Surgery, First People's Hospital Affiliated to Huzhou University Medical College, Huzhou, Zhejiang Province, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Bao
authors.affiliation: Department of General Surgery and Molecular Surgery, First People's Hospital Affiliated to Huzhou University Medical College, Huzhou, Zhejiang Province, China.
authors.forename: Mao Yun
authors.initials: MY
authors.lastname: Fei
mesh_terms: D000069287:Capecitabine / Q000009:adverse effects / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis
chemical_list: D000069287:Capecitabine
keywords: Chemotherapy; D2 gastrectomy; Gastric cancer; Recurrence