小肠原发恶性肿瘤根治术后辅助化疗疗效分析

Clinical Analysis of Postoperative Adjuvant Chemotherapy of Small Intestine Primary Malignancies

目的评价根治术后辅助化疗对小肠原发恶性肿瘤疗效的影响。方法回顾性分析解放军总医院2001年1月—2010年6月55例小肠原发恶性肿瘤根治术后患者的临床资料,主要终点观察指标是中位无疾病生存期,次要观察指标为1年、2年生存率,影响预后的因素。结果单纯手术组和术后辅助化疗组中位无疾病生存期(mDFS)(分别为15.0月、28.0月(P=0.035<0.05);1、2年无疾病生存率分别为61.1%、73.7%(P=0.351)和36.1%、56.0%(P=0.418);1、2年生存率分别为75.9%、100%(P=0.001)和68.0%、93.8%(P=0.025);肿瘤的浸润深度是影响患者预后的重要因素(P<0.05);而分化程度、临床分期、肿瘤大小及部位等对预后的影响没有统计学意义。结论根治术后辅助化疗具有能延长患者的无疾病生存时间的趋势,单纯手术组与术后辅助化疗组两组之间差异有统计学意义;肿瘤的浸润深度是影响预后的重要因素(P<0.05)。

Objective To evaluate the efficacy of postoperative adjuvant chemotherapy in patients with small intestine primary malignancies;Methods The clinical and follow-up date of 55 patients with small intestine primary malignancies who underwent surgery from January 2001 to June 2010 in our hospital were retrospectively analyzed, The primary end point was the median disease free survival rate and 1 and 2-year survival rates, affecting prognostics factors were evaluated. Results The median disease free sur- vival time was 15.0 month for the chemotherapy group and 28.0 month for the surgery group. （P = 0. 035 %（I. 05） ; the 1-year DFS was 6l. 1 % and 73.7% respectively（P = 0. 351 ）, the 2-year DFS was 36. 1 and 56. 0% ,respectively（P = 0.481 ） ; the 1-year survival rate was 75.9% and 100%, respectively（P = 0. 001 ） ; the 2-year survival rate was 68.0% and 93. 8%, respectively（P = 0. （125）. The depth of tumor was a predictor of poor prognosis;however,the differentiation degree, stage, size and place of tumor had no significance of prognosis. Conclusion Postoperative adjuvant chemotherapy may prolong the median disease free survival rate（P〈0. 05） ;both the surgery group and the postoperative adjuvant chemotherapy group has significant difference. The depth of tumor is a predictor of poor prognosis.