辅助化疗在不同分期胃癌治疗中的意义

Adjuvant chemotherapy for gastric cancer in different stages

目的:分析根治术后辅助化疗在各期胃癌根治术后患者中应用的临床意义。方法:回顾性分析2006年4月至2008年4月胃癌根治术后患者的临床病理资料,以COX多因素回归分析辅助化疗、TNM分期、年龄、性别、分化程度等多因素对患者预后的影响;分层分析研究辅助化疗在不同分期患者中对2年生存率的影响。结果:101例患者中,共有51例患者接受化疗,所使用的化疗方案均以氟尿嘧啶类药物为基础。Ⅲ期患者54例,化疗与未化疗患者2年生存率分别为85.70%和58.70%,差异有显著意义(P=0.01),COX多因素回归的方法分析发现辅助(P=0.008)及分化程度(P=0.001)是Ⅲ期患者生存的独立预后因素。结论:Ⅲ期胃癌术后的患者应常规接受辅助化疗,以氟尿嘧啶为基础的方案安全有效。

Objective To investigate the clinical significance of adjuvant chemotherapy for gastric cancer in different stages. Methods Clinical and pathologic data in patients with gastric cancer after radical resection from April 2006 to April 2008 were collected and divided into 2 groups according to receiving adjuvant chemotherapy or not （therapy group and control group）. Kaplain-Meier survival was used to analyze the difference of survival curve between the two groups. Effects of factors including adjuvant chemotherapy , TNM staging, age, gender, and tissue differentiation on the prognosis were analyzed by COX regression. And the effect of adjuvant chemotherapy on 2 year survival in patients with gastric cancer in different stages was analyzed. Results Among 101 recruited patients, 51 received adjuvant chemotherapy. Fluorouracil-based regimen was most commonly used. For stage Ⅲ patients, 2 year survival rate was 85.70% and 58.70% respectively in therapy group and control group,and the difference was significant（P = 0.01）. Tissue differentiation （P = 0.001） and adjuvant chemotherapy （P=0.008） were the independent prognostic factors for stage Ⅲ patients.Conclusion Patients with gastric cancer in stage Ⅲ should routinely receive adjuvant chemotherapy after surgery, and fluorouracil based regimens are safe and effective.