两种新辅助化疗方案应用于进展期胃癌术前治疗中的疗效研究

Research on the efficacy of two neoadjuvant chemotherapy treatments applied in the treatment advanced gastric cancer before operation

目的比较两种新辅助化疗方案应用于进展期胃癌术前治疗中的疗效。方法选择2008年3月~2014年3月在我院普外科和肿瘤科进行治疗的将110例进展期胃癌患者,将其分为A、B、C三组,A、B组在手术治疗前分别采用XELOX和FOLFOX化疗方案,C组采取单纯手术治疗,比较临床疗效和不良反应。结果 A组化疗后缓解率（69.0%）高于B组（67.6%）,但差异无统计学意义（P〉0.05）;A、B两组治疗后较治疗前肿瘤的平均体积显著缩小,差异有统计学意义（P〈0.05）。A、B两组根治性切除率（73.8%、70.3%）明显高于C组（45.2%）,差异有统计学意义（P〈0.05）,但A、B两组之间根治性切除率比较差异无统计学意义（P〉0.05）。B组在恶心呕吐、粒细胞减少、血小板减少、腹泻发生率方面均高于A组,在外周神经毒性发生率方面低于A组,差异有统计学意义（P〈0.05）。结论 XELOX方案和FOLFOX方案均可有效提高进展期胃癌患者的临床缓解率和手术根治性切除率,但前者不良反应更少,安全性更高,在临床应用中具有一定的优势。

Objective To compare the efficacy of two neoadjuvant chemotherapy treatments applied in the treatment before advanced gastric cancer operation. Methods A total of 110 cases of advanced gastric cancer patients who received treatment in department of general surgery and department of oncology of our hospital from March 2008 to March 2014 were chosen and analyzed, and these patients were divided into group A, group B and group C. Patients in group A and group B received XELOX chemotherapy treatment and FOLFOX chemotherapy treatment before operation respectively, and patients in group C received simple surgical treatment. The clinical efficacy and adverse reactions were compared. Results The remission rate of group A（69.0%） was higher than that of group B（67.6%）, but the difference was not statistically significant（P〉0.05）. The average tumor volumes of group A and group B after treatment significantly reduced, compared with those before treatment, the difference was statistically significant（P〈0.05）. The radical resection rates of group A and group B（73.8%, 70.3%） were significantly higher than those of group C（45.2%）, the difference was statistically significant（P〈0.05）, but the difference in radical resection rate between group A and group B was not statistically significant（P〉0.05）. The incidence rate of nausea and vomiting, neutropenia reduction, thrombocytopenia reduction, and the incidence rate of diarrhea in group B were higher than those in group A, and the outer peripheral neurotoxicity incidence rate in group B was lower than that in group A, the difference was statistically significant（P〈0.05）. Conclusion Both XELOX and FOLFOX can effectively improve the clinical remission rate and the surgical radical resection rate of patients with advanced gastric cancer, but the former can cause less adverse reactions, is more secure, and has certain advantages in clinical application.