进展期胃癌术后辅助性化疗的10年随访结果

TEN-YEAR FOLLOW-UP STUDY OF SUPPLEMENTARY CHEMOTHERAPY AETER GASTRIC SURGERY IN PATIENTS WITH ADVANCED GASTRIC CANCER

报告１０２例进展期胃癌术后患者，随机进行３组不同化疗方案并经平均随访１０．７年的结果。所有病例均为１９８３年５月到１９８５年５月间手术者。术后随机给予单一５－ＦＵ、５－ＦＵ＋ＣＣＮＵ和ＭＴＸ＋ＭＭＣ＋５－ＦＵ三组不同化疗。随访至１９９４年１２月止，死亡７７例，存活２５例。结果３、５和１０年总生存率分别为４２．１％；２９．４％和２４．５％。三组间比较，总生存率并无显著差异（Ｐ＞０．０５），但中位生存期单一－５－ＦＵ组明显优于其他２组，且毒副反应小，值得优先选择。按国际新ＴＮＭ分期，本组Ⅰ＿ｂ期５和１０年生存率均为１００％，Ⅱ期分别为８０．０％和７０．０％，远优于Ⅲ和Ⅳ期，提示除手术时所处的病期对估计胃癌预后具有重要意义外，还应归结于术后辅助化疗的作用。

One hundred and two patients with advanced gastric cancer were allocated random-ly into 3 regimen groups of chemotherapy following gastric surgery during the periodfrom May,1983 to May,1985. The 3 regimens were: 5-Fu,5-Fu + CCNU and MTX +MMC + 5-Fu. Until December 77 patients died and 25 were still alive. The 3-year,5-year,and 10-year survival rates of these 102 patients were 42.1%,29.4%and 24.5%,respectively. There was no statistically significant difference of survival rates observedamong these 3 regimen groups,however the median survival time of the 5-Fu regimengroup was much longer than the other 2 regimen groups. It is concluded that both TNMstaging and supplem ntary chemotherapy are two important factors influencing the prog-nosis of advanced gastric cancer post-gastric surgery.