肿瘤辅助化疗在胃癌肝转移中的疗效初步探讨

The effectiveness of neoadjuvant chemotherapy in the gastric cancer patients with liver metastasis: A preliminary study

目的评价肿瘤辅助化疗在胃癌肝转移中的近期疗效。方法2001年1月至2006年1月收治的40例胃癌肝转移的病人，给予全身静脉化疗，化疗方案为多西紫杉醇75mg／m^2，第1天，顺铂75mg／m^2，第1天，5-氟尿嘧啶500mg／m^2，第1-5天，甲酰四氢叶酸钙100mg／d静推，于应用5-氟尿嘧啶前30rain应用。3周为1个疗程，3个疗程后行超声内镜和螺旋CT等检查，视病人情况行手术治疗，对切除组织标本进行病理学检查。结果40例胃癌病人中，6例肝转移灶消失，14例肝转移灶部分消失，疾病稳定11例，疾病进展9例，20例获手术切除（50％）。病理学检查有3例完全缓解，17例部分缓解。结论肿瘤辅助化疗在降低胃癌肝转移的临床分期和提高手术切除率方面有一定作用。

Objective To evaluate the later effect of neoadjuvant chemotherapy in gastric cancer patients with liver metastasis. Methods From January 2001 to January 2006, 40 gastric cancer patients, complicated with liver metastasis, were treated with the intravascular neoadjuvant chemotherapy regimens, which contained docetaxel 75mg/m^2 at days 1 ,cisplatin 75 mg/m^2 at days 1, fluorouracil 500 mg/m^2 from days 1 to 5, and CF 100 mg half of hour before fluorouraeil. Three weeks were defined as one chemotherapy cycle. After three chemotherapy cycles, the ultrasound gastroscope and spiral CT was performed, and then the operation was performed according to the basic condition of the patients. At last, pathologic researches were carried on the excised cancer specimen to further compare its effectiveness. Results In the 40 stomach cancer patients with liver metastasis, 6 patients＇liver metastasis completely disapeared, 14 patients＇liver metastasis partly disappeared, 11 patients＇liver metastasis remained stabilization, only 9 cases＇condition aggravated. Among all the patients, 20 patients have the new chance to accomplish the surgical excision, and the excision rate reached 50%. Our pathology results further confirmed that 3 cases＇disease condition completely alleviated, and 17 cases partly alleviated. Conclusion The neoadjuvant chemotherapy maybe helpful to reduce the grades of clinical stages in the gastric cancer patients with liver metastasis, and thus increasing the second surgical resection rate.