胃癌综合治疗临床疗效分析

The Clinical Analyses of Therapeutic Effect of Comprehensive Therapy on Gastric Carcinoma

目的探讨胃癌患者综合治疗的临床疗效。方法回顾性分析收治的220例胃癌手术患者的临床资料。针对TNM分期采用相应的治疗方案,比较不同治疗组的R0切除率、术后2年复发率及死亡率。结果Ⅰ期患者均R0切除,无复发、死亡病例;Ⅱ期患者均R0切除,复发率为18.8%,死亡率为12.5%。Ⅲ、Ⅳ期新辅助化疗(NAC)组和常规化疗(CC)组R0切除率分别为73.8%、61.2%,比较差异有统计学意义(P<0.05);复发率分别为38.5%、46.3%,比较差异有统计学意义(P<0.05);死亡率分别为32.3%、34.3%,比较差异无统计学意义(P>0.05)。结论早期胃癌疗效好,实施胃癌缩小根治术安全有效;NAC能提高进展期胃癌R0切除率,降低术后复发率;合理施行以手术为主的综合治疗有助于改善胃癌预后。

Objective To observe the effect of comprehensive therapy on the patients with gastric carcinoma.Methods The prognostic factors of gastric carcinoma were analyzed based on clinical data of 220 cases with gastric carcinoma who underwent surgical treatment.The rates of curative resection,recurrence,and mortality were analyzed between the different stages which were parted by the method of TNM.Results The stage I gastric carcinomas were all radical resected and found no recurrence or died case;the rates of curative resection,recurrence,and mortality of the stage Ⅱ patients were 100.0%,18.8% and 12.5% respectively;the rates of curative resection,recurrence,and mortality of the new adjuvant chemotherpy（NAC）group and the common chemocherapy（CC） group were（73.8% vs 61.2%,P0.05）,（38.5% vs 46.3%,P0.05）,and（32.3% vs 34.3%,P0.05） respectively.Conclusion A suitable small resection operation for early gastric carcinoma is efficient and its prognoses are very good.NAC for the advanced gastric carcinoma is effective,which can improve the rate of curative resection and reduce the postoperative recurrence.Surgery-based comprehensive therapy used individually will improve the therapeutic effect of gastric carcinoma.