Publication:

Post treatment outcome and quality of life in patients with inoperable advanced gastric carcinoma

Background The outcome of treatment for advanced gastric carcinoma can vary depending on a number of factors, including the stage and aggressiveness of the cancer, the patient's overall health, and their response to treatment. In general, the prognosis is poor, with a median overall survival of less than one year. Quality of life (QOL) is an important consideration for patients with advanced gastric carcinoma, as they may experience a range of symptoms such as pain, fatigue, and difficulty eating. This study aimed to evaluate the post-treatment outcomes and QOL in patients with inoperable advanced gastric carcinoma after treatment with cisplatin-capecitabine and with oxaliplatin-capecitabine.

Methods This Quasi-experimental study was conducted at the department of oncology, Bangabandhu Sheikh Mujib medical university, Dhaka, Bangladesh. The study duration was 1 year, from February 2021 to March 2022. During this period, a total of 64 cases of advanced gastric cancer were divided in two equal groups, arm A who had received cisplatin capecitabine, and arm B who received oxaliplatin capecitabine.

Result The mean age at diagnosis was 55.85 and 56.76 respectively. The majority of the patients, 43.8% in arm A and 50% in arm B, ranged in age from 61 to 70. The gender distribution was similar, 78% and 69% of patients in arm A and B respectively were male. Both groups had the majority of patients receiving an ECOG performance rating of 2, with 68.8% in arm A and 59.4% in arm B, and the liver being the most common metastatic site for 56.3% in arm A and 50.0% in arm B. The most frequent risk factor was Helicobacter pylori infection, observed in 68.8% of arm A and 78.1% of arm B. The most common primary tumor site was the antrum, with 50% and 53.1% patients in arm A and B respectively had the primary tumor in the antrum of the stomach.

Conclusions In inoperable advanced gastric cancer, the cisplatin-capecitabine regimen is equally effective as oxaliplatin-capecitabine in terms of disease outcome. Furthermore, the cisplatin-capecitabine regimen is less costly than the combination of oxaliplatin-capecitabine, and provides almost similar QOL. As a result, the cisplatin-capecitabine regimen could be utilized as an alternate choice in patients who are unable to afford an oxaliplatin-based regimen.