胃癌术后免疫化疗的远期疗效评价

Evaluation of Long Term Effect for Gastric Cancer with Postoperative Immunochemotherapy

目的：为探讨术后免疫化疗在胃癌综合治疗中的远期疗效，本文对428例胃癌进行回顾性分析。方法：全部资料来自我院、西安交通大学第一附属医院1989／2001年收治的428例胃癌患者，并随机分为单纯手术组144例，术后化疗组138例，术后化疗免疫组146例。化疗组均给于术后化疗1～3a，观察其5a生仔率。结果：（1）单纯手术、术后化疗及术后免疫化疗组5a生存率分别为24．3％、38．4％和53．4％。术后免疫化疗组与单纯手术组间差异有显著性（P〈0.01）；5a生存率术后免疫化疗组较术后化疗组提高15．0％。（2）无淋巴结转移组中，单纯手术组，术后化疗组及术后免疫化疗组5a生存牢分别为29．3％、51．9％、66．7％。术后免疫化疗组与单纯手术组差异有显著性（P〈0．01），较术后化疗组5a生存率提高14．8％；有淋巴结转移组中，单纯下术组，术后化疗组及术后免疫化疗组5a生存率分别为14．8％、29．8％、44．2％。术后免疫化疗组与单纯手术组差异有显著性（P〈0.01），较术后化疗组5a生存率提高14．4％。结论：胃癌术后免疫化疗呵提高患者的生存期，其远期疗效明显优于术后化疗及单纯手术。对有／无淋巴结转移者，术后免疫化疗均有明显的远期疗效。

Objective：To evaluate the effect with postoperative immunochemotherapy for gastric cancer to 5-year survival rates of 428 patients. Methods：We have made a retrospective analysis on 428 cases of gastric cancer,who were hospitalized for treatment from 1989 to 1996. The cases were divided randomly into three groups,one group（144 cases） receiving simple operative treatment,one group（138 cases） receiving post operative chemotherapy（surgery＋chemotherapy）and one group（I/16 cases）receiving immunochemotherapy surgery（surgery＋immunoehemotherapy）to be evaluated the prognostic significance of treatment. Results ：The 5-year survival rates for the surgery alone group, the post opera rive chemotherapy group and the immunochemotherapysurgery group were 24.3% .38.4% and 53.4% ,respectively. Significant survival differences were observed hetween the immunochemotherapy surgery group and the surgery alone group （P〈0.01）The 5 year survival of the immunochemotherapy surgery group was 15.0% higher than that of the post-operative chemotherapy. In no lymph node metastases group,the 5 year survival rates for the surgery alone group,the post operative chemotherapy group and the immunochemotherapy surgery were 29.3%,51.9% and 66.7%,respectively. The patients given immunochemotherapy surgery significantly longer than those given surgery alone（P〈0.01）and post-operatine chemotherapy （P 〈0. 05）. In lymph node metastases group, the 5 year survival rates for the three group were 14.8%,29. 8% and 44. 2%,respectively. The patients given immunoehemotherapy surgery significantly longer than those given surgery alone（P〈0.01 ）and post-operatine chemotherapy（P〈0.05）. Conclusion ：The result shows that immunochemotherapy surgery can increase the patients survival period. The 5 year-survival rates of patients receiving im munoehcmotherapy surgery is better than that of the post operative chemotherapy or surgery alone. Consequently,ira munochemtherapy surgery should be the effective treatment strategy for gastric cancer with no lympy node or lymph node metastases.