胃癌根治术后采用替吉奥联合奥沙利铂辅助化疗的疗效及不良反应

Efficacy and Side Effects of Adjuvant Chemotherapy with S-1 Combined with Oxaliplatin after Radical Gastrectomy for Gastric Cancer

目的探讨胃癌根治术后采用替吉奥联合奥沙利铂辅助化疗的疗效及不良反应。方法选择胃癌患者95例,根据治疗方法的不同分为观察组50例与对照组45例。2组患者都给予手术治疗,对照组给予奥沙利铂辅助化疗,观察组给予替吉奥联合奥沙利铂辅助治疗,化疗观察2个周期。结果2组患者的手术时间、术中出血量、肿瘤距切缘距离对比差异无统计学意义(P>0.05),观察组的术后胃肠功能恢复时间、术后住院时间显著少于对照组(P<0.05)。2组化疗不良反应主要为肝功能异常、周围神经毒性、消化道反应、骨髓抑制等,以1~2级为主,无化疗相关死亡事件发生,对比差异无统计学意义(P>0.05)。随访至今,观察组的无复发生存期与总生存期都显著长于对照组(P<0.05)。化疗后随访3年,观察组的腹膜转移、淋巴结转移、肝脏转移等发生率分别为10.0%、8.0%和0.0%,对照组为24.4%、26.7%和13.3%,观察组少于对照组(P<0.05)。结论胃癌根治术后采用替吉奥联合奥沙利铂辅助化疗并不会增加不良反应的发生,还能促进患者的康复,降低术后肿瘤转移率,延长患者的生存时间。

Objective To investigate the efficacy and side effects of S-1 combined with oxaliplatin in adjuvant chemotherapy after radical gastrectomy for gastric cancer.Methods 95 cases of gastric cancer were selected and were divided into 50 cases in the observation group and 45 cases in the control group according to the different treatment methods.The 2 groups were treated with surgical treatment,the control group were given oxaliplatin adjuvant chemotherapy and the observation group were given S-1 combined with oxaliplatin adjuvant treatment,the chemotherapy were observed 2 cycles.Results There were no significant difference compared between the 2 groups in the operation time,the amount of bleeding and the distance to the margin of the tumor(P>0.05),the recovery time of the gastrointestinal function and the hospitalization time after operation were significantly less than that of the control group(P<0.05).The 2 groups of adverse reactions were mainly liver dysfunction,peripheral neurotoxicity,digestive tract reaction,bone marrow suppression and so on,the main adverse reactions were grade 1-2 and there were no chemotherapy related deaths occurred,compared the difference were not statistically significantly(P>0.05).After followed-up,the recurrence free survival and overall survival of the observation group were significantly longer than those of the control group(P<0.05).After 3 years of followed-up after chemotherapy,the incidence of peritoneal metastasis,lymph node metastasis and liver metastasis in the observation group were 10.0%,8.0%and 0.0%respectively,and the control group were 24.4%,26.7%and 13.3%,and the observation group were less than the control group(P<0.05).Conclusion The adjuvant chemotherapy with S-1 combined with oxaliplatin after radical gastrectomy does not increase the incidence of adverse reactions,it can promote the recovery of the patients,reduce the rate of postoperative tumor metastasis and prolong the survival time of the patients.