术前TPF方案冲击化疗在进展期胃癌的临床跟踪研究

A tracing study on preoperative short course chemotherapy with TPF regimen in advanced gastric cancer

目的研究术前TPF方案短程冲击化疗对进展期胃癌肿瘤细胞凋亡的影响。方法从56例未经治疗的局部进展期胃癌患者中随机抽取36例,以第1天静滴多西紫杉醇(多帕菲)70～75mg/m2、静滴顺铂20mg/d×5d和5-FU0.75/d×5d为主的术前短程冲击化疗;其余20例为空白对照组。观察化疗后原发病灶中肿瘤细胞的凋亡指数和毒副反应。跟踪研究术后3年。结果化疗后所有患者均行根治性手术。术前化疗组肿瘤细胞凋亡指数明显高于对照组[(26.85±12.02)vs.(9.12±7.03)](P<0.01)。毒副反应主要为白细胞减少症(0～I级)、腹泻、恶心呕吐、脱发等,但不影响正常手术。术前化疗组3年生存率明显高于对照组[(72.2%vs.65%)](P<0.05)。结论术前短程冲击化疗能有效促进胃癌细胞调亡,不影响正常手术治疗,能显著延长患者术后生存时间。

Objective To investigate the effects of preoperative short course chemotherapy with TPF regimen on advanced gastric cancer.Methods Of 56 untreated subjects with local advanced gastric cancer,randomly selected 36 cases（group A） received one course of preoperative chemotherapy with intravenous injection of docetaxel 70-75 mg/m2 on the first day,cisplatin 20 mg/d and 5-FU 0.75/d for 5 days.The other 20 cases（group B） were not given preoperative chemotherapy as the controls.The apoptosis index of cancer cells in the primary lesion after chemotherapy and the toxic effects were observed.All cases were followed up for three years after radical surgery.ResultsRadical operations were performed on all 56 patients.The apoptosis index of cancer cells was higher in group A than that in group B ／[（26.85±12.02） vs.（9.12±7.03）／]（P0.01）.Toxic effects of group A were mainly leukopenia（0-Ⅰ）,diarrhea,nausea,vomiting and alopecia,which did not affect the surgery.The three-year survival rate was higher in group A than that in group B ／[（72.2% vs. 65%）／]（P0.05）.Conclusion The preoperative short course chemotherapy can effectively enhance apoptosis of cancer cells without influence on the surgery and prolong the three-year survival rate.