局部进展期胃癌的新辅助化疗及联合脏器切除术疗效分析

Efficacy of neoadjuvant chemotherapy and multivisceralresection for locally advanced gastric carcinoma

目的探讨新辅助化疗联合脏器切除的胃癌根治术对局部进展期胃癌的疗效及并发症影响。方法选取该院1999～2006年局部进展期胃癌50例,根据新辅助化疗疗效及手术情况分为3组,A组(n=15):新辅助化疗肿瘤缩小联合脏器切除的胃癌根治术,术前新辅助化疗及术后化疗方案为mFOLFOX6;B组(n=6):新辅助化疗肿瘤稳定联合脏器切除的胃癌根治术,术前新辅助化疗方案同A组,术后辅助化疗方案为DCF;C组(n=29):新辅助化疗肿瘤稳定或进展未联合手术治疗,化疗方案同B组。结果 A、B、C组1年生存率分别为100.0%、83.3%和20.7%(P=0.000)。A和B组虽然有少数病例术后出现吻合口瘘,但经保守治疗后可痊愈。结论新辅助化疗联合脏器切除的胃癌根治术可改善局部进展期胃癌患者预后,且并发症可控制。

Objective To investigated the efficacy and the postoperative complication for the locally advanced gastric carcinoma with the therapy of neoadjuvant chemotherapy and mutivisceralresection. Methods Selected the 50 locally advanced gastric carcinoma cases,had been divided into 3 groups according to the neoadjuvant chemotherapy＇and wether or not had multivisceralresection from 1999 to 2006,The A group had 15 cases,which the tumour became small after neoadjuvant chemotherapy and had been taken mutivisceralresetion, the chemotherapy plan ban been continued after oparation. In which, the preoperative neodjuvant and postoperative chemotherapy plan was mFOLFOL6. The B group had 6 case,which the tumour did not became small after neoadjuvant chemotherapy and had been taken mutivisceralresetion,after the operation. In this group,preoperative neoadjuvant chemotherapy with A group and the chemotherapy plan were DCF. The C group hand 29 cases,which the tumour did not became small after neoadjuvant chemotherapy and patients＂ families had refused been taken mutivisceralresetion, In which, gived the same chemotherapy with B group. Results In A group,B group,C group and 1 year survival rates were 100.0% ,83.3% and 20.7^ （P=0. 000）. The A and B groups although there are a few cases of postoperative anastomotic fistula. But after conservative treatment can be cured. Conclusion The method of neoadjuvant chemotherapy and multivisceralresection can improve the prognosis of patients with locally advanced gastric cancer,and the complications can be controlled.