ⅠB～Ⅲ期胃癌术后患者同步放化疗和单纯化疗的疗效研究

Clinical Effects of Stage ⅠB～Ⅲ Gastric Cancer Treated by Concurrent Chemoradiotherapy and Simple Chemotherapy

目的探讨ⅠB-Ⅲ期胃癌术后患者同步放化疗和单纯化疗的不同疗效。方法随机抽取115例胃癌根治术并完成术后辅助治疗的ⅠB-Ⅲ期胃癌患者,按照临床治疗方法不同将患者分为同步放化疗组(58例)和单纯化疗组(57例)。同步放化疗组患者进行3个周期的m FOLFOX方案化疗,化疗结束后2周,进行放疗。单纯化疗组患者化疗药物及时间同同步放化疗组。患者随访2年。观察患者生活质量评分情况、不良反应发生情况、生存情况、远处转移情况、复发情况。结果两组患者生活质量评分(吞咽困难、疼痛、反流、进食受限、焦虑、口干、脱发)比较,差异无统计学意义(P>0.05)。两组患者不良反应比较,同步放化疗组患者恶心、呕吐、腹泻、手足综合征发生率高于单纯化疗组,差异有统计学意义(P<0.05)。同步放化疗组患者2年生存率、3年生存率高于单纯化疗组,差异有统计学意义(P<0.05)。两组患者1年生存率比较,差异无统计学意义(P>0.05)。同步放化疗组患者3年局部复发率低于单纯化疗组,差异有统计学意义(P<0.05)。两组患者3年远处转移率比较,差异无统计学意义(P>0.05)。结论ⅠB-Ⅲ期胃癌术后患者同步放化疗对患者生活质量无明显影响,能够增高患者2年、3年生存率,减少局部复发,但不良反应恶心、呕吐、腹泻、手足综合征发生率较高,临床需引起重视。

Objective To explore the clinical effects of stage ⅠB ~ Ⅲ gastric cancer treated by concurrent chemoradiotherapy and simple chemotherapy.Methods 115 cases of patients with gastrectomy were divided into concurrent chemoradiotherapy group（58 cases） and simple chemotherapy group（57 cases）.Concurrent chemoradiotherapy group received 3 cycles of m FOLFOX,2 weeks after chemotherapy received radiotherapy.Simple chemotherapy group received the same chemotherapy treatment as concurrent chemoradiotherapy group.Patients were followed up for 2 years.Scores of quality of life,toxicity,survival situation,distant metastases situation,and recurrence were observed.Results There had no significant difference in the scores of quality of life（dysphagia,pain,reflux,eating is limited,anxiety,dry mouth,alopecia） between the 2 groups（P〉0.05）.The rates of nausea,vomit,diarrhea,hand-foot syndrome of concurrent chemoradiotherapy group were higher than those of simple chemotherapy group（P〈0.05）.2-and 3-year survival rates of concurrent chemoradiotherapy group were higher than those of simple chemotherapy group（P〈0.05）.There had no significant difference in 1-year survival rates（P〉0.05）.3-year local recurrence rate of concurrent chemoradiotherapy group was lower than that of simple chemotherapy group（P〈0.05）.There has no significant difference on the 3 year distant metastasis（P〉0.05）.Conclusion It has no significantly influence on stage ⅠB-Ⅲ gastric cancer treated by concurrent chemoradiotherapy,it can improve 2-and 3-year survival rates,reduce local recurrence,with high rates of nausea,vomit,diarrhea,and hand-foot syndrome,it needs attention in clinical application.