新辅助化疗在进展期胃癌中的临床应用

Pre-operative neoajuvant chemotherapy in patients with advanced gastric cancer

目的评估进展期胃癌患者新辅助化疗的治疗效果。方法选择2011年9月至2014年12月安徽省肿瘤医院收治进展期胃癌患者70例,根据治疗方法,70例患者分为新辅助化疗组(46例)和单纯手术组(24例)。新辅助化疗组患者进行3个周期的XELOX方案新辅助化疗再行手术,两组患者均接受标准胃癌切除手术,观察评估化疗疗效并对比手术治疗效果。结果新辅助化疗组患者化疗有效率为63.04%。新辅助化疗组患者的R0切除率为94.48%,R1或R2切除率为6.52%,单纯手术组患者的R0切除率为70.83%,R1或R2切除率为29.17%,新辅助化疗组患者的R0切除率明显高于单纯手术组(P<0.05)。两组均无手术死亡病例,术后并发症发生率差异无统计学意义(P>0.05)。结论 XELOX方案可作为有效的进展期胃癌新辅助化疗方案,进展期胃癌患者在新辅助化疗后再进行手术治疗,可以提高手术根治率和切除率。

Objective To explore the therapeutic effect of neoadjuvant chemotherapy on advanced gastric cancer. Methods Seven-ty patients with advanced gastric cancer were divided into neoajuvant chemotherapy group and routine surgical operation group. The patients in neoajuvant chemotherapy group received there cycles of neoajuvant chemotherapy,and then treated with surgery. The effect of chemotherapy was observed and the effect of surgery was compared. Results The overall response rate of neoadjuvant chemotherapy was 63. 04% . In neo-ajuvant chemotherapy group,the R0 resection rate was 94. 48% ,and R1 or R2 resection rate was 6. 52% . In routine surgical operation group,the R0 resection rate was 70. 83% ,and R1 or R2 resection rate was 29. 17% ;compared with the routine surgical operation group,R0 resection rate was significantly higher in the neoadjuvant chemotherapy group(P < 0. 05). There was no significant difference between both groups in terms of toxicities. Conclusion The overall resectability rate and the curative resection rate are increased in patients with ad-vanced gastric cancer after neoajuvant chemotherapy.