局部进展期胃癌术后放化疗与单纯化疗的对比研究

Comparision of postoperative radiochemotherapy with chemotherapy alone in the treatment of locally advanced gastric cancer

目的比较局部晚期胃癌根治术后同步放化疗(RCT)与单纯化疗(CT)的疗效及不良反应。方法对76例接受胃癌根治术(R0切除,D2淋巴结清扫)、病理诊断为Ⅱ-Ⅳ期的患者的预后进行分析,其中31例接受术后放化疗,45例接受术后化疗,评价两组的2、3年生存率,无复发生存率及治疗期间的毒性反应。结果 RCT组和CT组的2年生存率分别为85.5%和72.3%,3年生存率分别为69.2%和40%(P=0.045);2年无复发生存率分别为74.7%和48.6%,3年无复发生存率分别为49.8%和30.1%(P=0.041)。3级以上血液毒性发生率分别为20.7%和17.1%(P=0.373),胃肠道反应发生率为93.1%和63.4%(P=0.034)。结论局部晚期胃癌根治术后同步放化疗可以提高生存率及无复发生存率,不良反应可耐受。

Objective To investigate the efficacy and tolerance of postoperative concurrent chemoradiothera- py （RCT） and chemotherapy （CT） for gastric cancer. Methods The 76 patients who met the following enrolled cri- teria were included in the study：underwent curative gastrectomy and D2 lymphadenectomy , pathologically staged as II-IV. 31 cases were assigned to concurrent chemoradiotherapy group and 45 cases were in chemotherapy group. Then,2 or 3 - year survival rate and toxicity of the two groups were evaluated. Results The 2 - year survival rates for RCT and CT groups were 85.5% and 72.3% respectively,3 -year survival rates for RCT and CT groups were 69.2% and 40% （ P = 0.045 ） respectively. The 2 - year recurrence-free survival rates（RFS） for RCT and CT groups were 74.7% and 48.6% respectively,3 - year recurrence-free survival rates for RCT and CT groups were 49.8% and 30.1% （P = 0.041 ）respectively. The incidence of grade 3 hematological toxicity was20.7% vs17.1% （P = 0. 373 ）, and gastrointestinal toxicity was93.1% vs 63.4% （ P =0. 034）. Conclusions The chemotherapy combined with con- formal intensity-modulated radiotherapy can improve survival rate and their prognosis.