进展期胃癌新辅助化疗效果的临床观察

Clinical study of therapeutic effect of neoadjuvant chemotherapy for advanced gastric carcinoma

目的评估新辅助化疗对进展期胃癌的治疗效果。方法选取48例进展期胃癌(IIIb和IV期)患者,术前行氟尿嘧啶+甲酰四氢叶酸钙+乐沙定化疗,采用双周疗法;经2～3个疗程后,行CT,超声内镜复查,分期。对可切除者行手术治疗。结果新辅助化疗总有效率为58.4%;其中IIIb期为64.1%,IV期为22.2%。39例III期患者中,手术根治率达71.8%。9例IV期患者中,2例行姑息手术切除,1例行探腹术。结论新辅助化疗可有效提高IIIb期胃癌患者的手术根治率,而对IV期患者疗效不显著。

Objective To evaluate the therapeutic effect of neoadjavunt chemotherapy for gastric carcinoma. Methods Forty-eight gastric carcinoma patients（ stage b and Ⅳ ） were selected. Pre-operatively, they received a two-week regimen of oxaliplatin, 5 -Fu and CF. After 2 - 3 cycles treatment, CT and gastroscopy were used to determine resectability and then operation was performed. Results The total efficiency of neoadjuvunt chemotherapy was 58.4% , while it was 64. 1% for stage Ⅲb and 22.2% for stage Ⅳ cases. In 39 stage III patients, the radical resection rate was71. 8% o In 9 stage Ⅳ patients, 2 were received palliative resection and one underwent simple abdominal exploration. Conclusions Neoadjuvant chemotherapy could effectively increase the radical resection rate of stage Ⅲ gastric carcinoma patients, but the therapeutic effect was not significant for stage Ⅳ patients.