奥沙利铂联合氟尿嘧啶和亚叶酸钙行新辅助化疗治疗进展期胃癌的临床疗效研究

Oxaliplatin in Combination with Fluorouracil and Calcium Folinate as Neoadjuvant Chemotherapy for Patients with Advanced Gastric Cancer

目的探索奥沙利铂联合氟尿嘧啶和亚叶酸钙行新辅助化疗治疗进展期胃癌的临床疗效。方法回顾性分析中国医科大学附属盛京医院和北京市通州区潞河医院1995—2008年134例进展期胃癌患者的临床资料,根据治疗经过分为对照组和治疗组,其中对照组76例,行常规手术+术后化疗或直接化疗;治疗组58例,采用新辅助化疗+手术的综合治疗。结果治疗组患者应用FOLFOX方案行新辅助化疗的临床疗效为完全缓解6例(10.3%),部分缓解33例(56.9%),疾病稳定14例(24.1%),疾病进展5例(8.6%),总有效率为67.2%,毒副作用在可耐受范围。两组患者手术切除率及根治率比较,差异均有统计学意义(P<0.05)。对照组76例患者,71例获得随访,随访率93.4%;治疗组58例,53例获得随访,随访率91.4%,两组3年生存率比较差异有统计学意义(P=0.008)。结论术前采用新辅助FOLFOX方案治疗进展期胃癌疗效确切,毒副作用轻,可明显提高手术切除率、根治率及3年生存率。

Objective To evaluate the efficacy and toxicity of oxaliplatin combined with fluorouracil and leucovorin as neoadjuvant chemotherapy（NACT） in treating advanced stomach cancer.Methods Totally 134 patients with advanced gastric cancer from Shengjing Hospital,China Medical University,and Luhe Hospital（Tongzhou District,Beijing）,were divided into NACT group（n=58） and control group（receiving conventional surgery and postoperative chemotherapy;n=76）.Results The treatment responses in the NACT group included CR（n=6,10.3%）,PR（n=33,56.9%）,SD（n=14,24.1%）,and PD（n=5,8.6%）,yielding a total effective rate of 67.2%;meanwhile,the toxicity can be tolerated.The proportions of surgical resection and radical resection rates were significantly lower in NACT group than the control group（P0.05）.The follow-up rate was 93.4%（n=71） in the control group and 91.4%（n=53） in the NACT group,during which the 3-year survival rate showed significant difference（P=0.008）.Conclusion Oxaliplatin combined with fluorouracil and leucovorin as NACT is effective and safe in treating advanced gastric cancer in terms of resection rate,proportion of radical surgery,and 3-year survival.