进展期胃癌腹腔镜手术前辅以FOLFOX4化疗方案的临床效果

Clinical effect of chemotherapy regimen with FOLFOX4 before laparoscopic surgery for advanced gastric cancer

目的研究进展期胃癌腹腔镜手术前辅以FOLFOX4化疗方案的临床效果。方法选择2014年1月至2017年10月我院和西京医院收治的60例进展期胃癌患者为研究对象,根据随机数字表法将其分为对照组和观察组,每组30例。对照组予以腹腔镜手术治疗,观察组予以术前FOLFOX4化疗方案+腹腔镜手术。比较两组患者的临床治疗效果、血清相关指标表达情况、不良反应发生情况、术后1年复发和生存情况。结果观察组治疗总有效率和1年内存活率均高于对照组,差异具有统计学意义(P<0.05);治疗前,两组的PADI4、cAT、VEGF、IGF-1水平比较,差异无统计学意义(P>0.05);治疗后,两组的PADI4、cAT、VEGF、IGF-1水平均显著降低,且观察组低于对照组,差异有统计学意义(P<0.05);两组的不良反应总发生率比较,差异无统计学意义(P>0.05);观察组1年内复发率低于对照组,差异具有统计学意义(P<0.05)。结论腹腔镜手术前辅以FOLFOX4化疗方案应用于进展期胃癌患者中的疗效确切,安全性高,有助于减少复发情况,提高患者的生存率。

Objective To study the clinical effect of chemotherapy regimen with FOLFOX4 before laparoscopic surgery for advanced gastric cancer. Methods A total of 60 patients with advanced gastric cancer admitted in our hospital and Xijing Hospital from January 2014 to October 2017 were selected as the research objects. According to the random number table method, the patients were divided into control group and observation group, with 30 cases in each group. The control group received laparoscopic surgery, while the observation group received preoperative chemotherapy regimen with FOLFOX4+laparoscopic surgery. The clinical treatment effect, serum related indicators expression levels, adverse reactions, recurrence and survival rate at 1 year after surgery were compared between the two groups. Results The total effective rate of treatment and 1-year survival rate of the observation group were higher than those of the control group, and the differences were statistically significant (P<0.05). Before treatment, there were no significant differences in the levels of PADI4, cAT, VEGF and IGF-1 between the two groups (P>0.05). After treatment, the levels of PADI4, cAT, VEGF and IGF-1 in the two groups decreased significantly, and those in the observation group were lower than the control group, the differences were statistically significant (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). The recurrence rate within 1 year of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Chemotherapy regimen with FOLFOX4 before laparoscopic surgery in patients with advanced gastric cancer has definite efficacy and high safety, which is helpful to reduce recurrence and improve the survival rate of patients.