晚期胃癌患者卡培他滨联合紫杉醇新辅助化疗的临床观察

Clinical report of neoadjuvant chemotherapy of capecitabine plus taxol for the preoperative patients with advanced gastric cancer

目的:了解晚期胃癌术前应用卡培他滨联合紫杉醇方案进行新辅助化疗的疗效和毒副反应。方法:84例晚期胃癌患者中,试验组42例术前接受辅助化疗:卡培他滨1650mg/(m2.d),口服,d1～d14;紫杉醇175mg/(m2.d),静脉滴入,d1。每3周为1个周期,连用2个周期,新辅助化疗结束2～4周后行手术治疗。对照组42例在确诊后2周内行手术治疗。84例患者均行胃癌根治术(D2式淋巴结清除)。结果:试验组和对照组术后复发率分别为35.7%(15/42)和61.9%(26/42),2年生存率分别为59.5%(25/42)和19.0%(8/42),两组比较差异有统计学意义,χ2值分别为5.765和14.424,P值分别为0.016和0.001。试验组和对照组中位生存期分别为24.2和12.6个月。结论:术前应用卡培他滨联合紫杉醇方案进行新辅助化疗是目前治疗晚期胃癌较理想的方案。

OBJECTIVE： To study the efficacy and adverse effect of neoadjuvant chemotherapy of capecitabine plus taxol for the preoperated patients with advanced gastric cancer. METHODS： From January, 2001 to January,2005, 84 patients with advanced gastric cancer were randomized into 2 groups： 42 cases were treated as a test group with capecitabine 1 650 mg/（m^2 · d） p.o. for 14 days, taxol 175 mg/（m^2 · d）,intravenous infusion d1 beforeoperation, the two regimens were repeated every three weeks and totally two cycles, and the patients received operation 2-4 weeks after the completion of neoadjuvant chemotherapy; 42 cases of the control group received the operation within two weeks after confirming by pathological examinations. All the patients received curative resection（D2 lymphadenectomy）. RESULTS： All the 84 patients had evaluable lesions. The recurrence rate of patients in the test group was 35.7%（15/42）, and the recurrence rate in the control group was 61.9% （26/42）. The statistical difference between the two groups was significant, x^2= 5. 765,P= 0. 016. The 2-year survival rate of patient in the test group was 59.5%（25/42）, and the 2-year survival rate in the control group was 19.0%（8/42） ; e =14. 424, P=0. 001. The median survival time （MST） in the test group was 24.2 momths, and MST in the control group was 12.6 momths. CONCLUSION： Neoadjuvant chemotherapy of capecitabine plus taxol is effective in the treatment of preoperative patients with advanced gastric cancer.