局部进展期胃癌术后同步放化疗近期疗效与毒副作用分析

Analysis of short-term effect and toxic and side effect by concurrent radiochemotherapy after surgery of locally advanced gastric carcinoma

目的：探讨术后同步放化疗与单纯化疗对Ⅱ-Ⅲ期胃癌患者2年生存率的影响及近期毒副反应。方法回顾性分析本院2010年2月-2012年6月收治的49例Ⅱ-Ⅲ期胃癌根治术后患者，根据治疗方案的不同分为两组。同步放化疗组（n=24）：XELOX方案化疗2周期，同步口服卡培他滨（825 mg/m2，2次/d）放疗，放疗结束后再行2周期化疗；单纯化疗组（n=25）：XELOX方案化疗4-6周期。通过定期随访，比较两组的2年生存率、无复发生存率和治疗期间的毒副作用。结果同步放化疗组和单纯化疗组2年生存率分别为87.5%和64.0%，2年无复发生存率分别为70.8%和48.0%，差异均有统计学意义（P〈0.05）。两组血液学毒性、消化道反应及手足综合征比较差异无统计学意义。结论Ⅱ-Ⅲ期胃癌术后行同步放化疗可提高患者2年生存率及无复发生存率，毒副反应可耐受。

Objective To explore the influence of 2-year survival rate and short-term toxic and side effects in patients with stage II-Ⅲ gastric cancer after surgeries by concurrent radiochemotherapy and only chemotherapy. Methods 49II-Ⅲ stage gastric cancer patients admitted into our hospital and undergone radical operation from February 2010 to June 2012 were retrospectively analyzed.According to different therapeutic regimens,they were divided into two groups：concurrent radiochemotherapy after surgery group and only chemotherapy after surgery group.In the former group（n=24）, XELOX regimen of chemotherapy was used for two weeks,and oral administration of capecitabine （825 mg/m2）twice per day for radiotherapy,and finally for two-week chemotherapy after radiotherapy was finished.In the latter one （n=25, XELOX regimen of chemotherapy was adopted for 4 to 6 weeks.The 2-year survival rate,survival rate without recur-rence,toxic and side effects during treatment were compared by regular follow up. Results The 2-year survival rate in concurrent chemoradiotherapy group and only chemotherapy group was 87.5% and 64.0% respectively.The survival rate of recurrence-free within 2 years in both groups was 70.8%and 48.0% respectively,with statistical difference （P〈0.05）. There was no significant difference in hematological toxicity,gastrointestinal reaction and hand-foot syndrome between two groups. Conclusion Concurrent chemoradiotherapy after operation for gastric carcinoma at stages ofII-Ⅲ can im-prove 2-year survival rate and survival rate of recurrence-free with tolerant toxic and side effect.