Abstract: Objective To compare the efficacy and safety of paclitaxel plus cisplatin and fluorouracil（PCF） and paclitaxel plus oxaliplatin and capecitabine（POX） as firstline therapy for advanced gastric cancer（AGC）. Methods In this randomized study， 58 patients with AGC were randomly assigned to either paclitaxel 135mg／m2 on day 1 plus cisplatin 20mg／m2 on d1-3 and fluorouracil 500mg／m2 on d1-5 in a 21-day cycle（PCF regimen， n=30） or paclitaxel 135mg／m2on day 1 plus oxaliplatin 100mg／m2 on day 1 and capecitabine 1000mg／m2 twice daily on d1-14 in a 21-day cycle（POX regimen， n=28）.
ResultsThe efficacy and toxicity could be assessed among all patients. There were no significant differences in therapeutic efficacy between PCF and POX regimen with respect to response rate（46.7％ vs.53.6％）， disease control rate（76.7％ vs. 85.7％）, median progression-free survival（5.8 months vs. 6.5 months） and overall survival（10.2 months vs.11.6 months）， respectively. Grade 3／4 neutropenia was more frequent with PCF regimen than POX regimen（30.0％ vs. 7.1％）， while diarrhea（42.9％ vs. 16.7％） and peripheral neuropathy（50.0％ vs.23.3％） occurred more frequently with POX regimen. Conclusion PCF and POX regimen had similar efficacy for the firstline treatment of AGC， with different side effects， but acceptable toxicity profiles. POX regimen seemed to be more safe and convenient.