Ⅲ期胃癌根治术后两药和三药联合化疗的疗效

Clinical efficacy of two-and three-drug chemotherapy schemes in treating gastric cancer at stage Ⅲ after radical resection

目的比较两药和三药联合化疗方案在Ⅲ期胃癌患者的疗效。方法Ⅲ期胃癌根治术后患者115例随机分为两组,分别实施两药联合(A组,61例)和三药联合(B组,54例)化疗,比较两组临床疗效和不良反应发生情况。结果 A组和B组3年生存率、中位无进展生存期和3年无复发率均无统计学差异(75.41%vs.74.07%、56.70个月vs.63.03个月和50.82%vs.51.85%)(P>0.05)。两组不良反应主要包括骨髓抑制、肝肾功能损伤、胃肠道反应和神经系统毒性等;A组Ⅱ-Ⅳ度贫血和乏力的发生率低于B组(14.75%vs.31.48%和27.87%vs.46.30%)(P<0.05)。结论与两药联合化疗相比,Ⅲ期胃癌根治术后三药联合化疗效果未明显改善,但不良反应有所增加。

Objective To compare the clinical efficacy of two- and three-drug chemotherapy schemes in treating gastric cancer at stage Ⅲ after radical resection .Methods A total of 115 patients with gastric cancer at stage Ⅲ after radical resection was randomly divided into two groups of A （treated with two-drug scheme chemotherapy ,61 cases ） and B （treated with three-drug scheme chemotherapy ,54 cases ） .The clinical outcomes and adverse effects were compared between two groups .Results The 3-year survival rate ,median disease-free survival and 3-year recurrence-free survival in group A were not statistically different from those in group B（75.41% vs .74.07% ,56.70 months vs .63.03 months and 50.82% vs .51.85% ） （ P〉0 .05 ） .The major adverse effects were myelosuppression ,injury of hepatic and renal function ,gastrointestinal reaction and toxicity of nervous system .The incidence rates of anemia of Ⅱ-Ⅳ degrees and fatigue in group A were lower than those in group B（14.75% vs .31.48% and 27.87% vs .46.30% ）（P〈0 .05） .Conclusion Compared with two-drug scheme chemotherapy ,the three-drug scheme chemotherapy does not improve the clinical outcomes ,but increases chemotherapy-related adverse effects in the patients with gastric cancer at stage Ⅲ after radical resection .