Objective  This study aimed to compare the efficacy and adverse reactions of two different chemotherapeutic regimens.In particular, chemotherapy with paclitaxel liposome was administered in combination with either S-1 or oxaliplatin as the first-line therapy of advanced gastric cancer.

  Methods  A total of 118 patients with advanced gastric cancer were randomly divided into groups A (61 cases) and B (57 cases).In group A, paclitaxel liposome combined with S-1 was administered; in group B, paclitaxel liposome combined with oxaliplatin was applied.The short-term efficacy, adverse reactions, Karnofsky performance status score, median time to progression (mTTP), and median overall survival (mOS) of the two groups were observed and compared.

  Results  No significant differences were observed in the objective response rate, disease control rate, and mTTP between groups A and B (31.1% vs. 29.8%, 75.4% vs.71.9%, 4.2 months vs.3.8 months; P > 0.05).The mOS rates were 10.5 and 8.9 months in groups A and B, respectively, with statistically significant differences (P=0.006).The incidence of degrees Ⅲ to Ⅳ diarrhea and peripheral nerve toxicity was significantly higher in group B than in group A (P < 0.05).No statistical differences were found between the two groups in terms of other side effects.

  Conclusion  The two paclitaxel liposome-based regimens showed similar therapeutic effect in patients with advanced gastric cancer.S-1/paclitaxel liposome treatment could be more effective in terms of mOS and had a tendency of lower toxicity.