中晚期胃癌术前新辅助化疗92例分析

Analysis of 92 cases of neoadjuvant chemotherapy in the advanced carcinoma of stomach

目的评价中晚期胃癌术前新辅助化疗的作用。方法总结2003年至2008年间92例入院后经CT、B超、胃镜等检查后诊断为中晚期胃癌并通过新辅助化疗后再行手术治疗的病例,并与2000年至2002年间收治的未经新辅助化疗的中晚期胃癌49例对照分析。结果化疗组肿瘤缩小或明显缩小者66例(71.7%),行根治性手术切除者69例(75%),行局部切除者17例(18.5%),姑息性手术者6例(6.5%)。对照组行根治性手术切除者24例(48.9%),行局部切除者15例(30.6%),姑息性手术者10例(20.4%)。所有病例均术后经病理证实,化疗组Ⅲa期46例,Ⅲb期33例,Ⅳ期13例,对照组Ⅲa期25例,Ⅲb期16例,Ⅳ期8例。结论对于以往手术切除较为困难或根治率低的中晚期胃癌,术前配合新辅助化疗,可提高手术切除率及根治率。

Objective To evaluate the clinical effectiveness of neoadjuvant chemotherapy in the treatment of advanced gastric cancer patients retrospectively. Methods Clinical data of 92 cases of advanced gastric cancer diagnosed by CT and B - uhrasonography and gastroscopy etc from 2003 to 2008 were summarized, and 49 cases of advanced gastric cancer not treated with neoadjm, ant chemotherapy from 2000 to 2002 were summarized as controls. Results Shrinkage of tumor was observed in 71.7% of the cases （66/92） through imageology examination. The radical surgery rate was 75% （69/92）, the local excision rate was 18.5% （17/92） , the palliative surgery rate was 6.5% （6/92）, and there were 46 ca- ses of stage Ⅲa, 33 cases of Ⅲb, and 13 cases of IV. In the control group, the radical surgery rate was 48.9% （24/49）, the local excision rate was 30. 6% （ 15/49）, the palliative surgery rate was 20. 4% （10/49） , and there were 25 cases of stage Ⅲ a, 16 cases of Ⅲ b and 8 cases of Ⅳ. Conclusion In combination with preoperative neoadjuvant chemotherapy, the radical surgery rate was raised in advanced gastric cancer difficult to be resected in the past.