局部进展期胃癌应用XELOX方案新辅助化疗的疗效分析  

Efficacy analysis of XELOX neoadjuvant chemotherapy in locally advanced gastric cancer

作　　者：陈国平 王群伟[2] 段文斌[2] 

机构地区：[1]湖南省芷江侗族自治县人民医院普外科,湖南怀化419100 [2]中南大学湘雅二医院微创外科中心,湖南长沙410011

出　　处：《中国现代医学杂志》2011年第29期3710-3714,共5页China Journal of Modern Medicine

摘　　要：目的分析局部进展期胃癌应用XELOX方案新辅助化疗的疗效。方法统计该院及中南大学湘雅二医院2010年5月～2011年5月37例应用XELOX方案实施新辅助化疗的局部进展期胃癌病例的临床资料,分析其疗效。结果全组37例患者在完成两周期化疗后均可评价疗效,其中CR5例(13.5%),PR14例(37.8%),NC15例(40.5%),PD3例(8.1%),RR51.3%(19/37)。所有患者均在两周期化疗后的2～3周内行手术治疗,根治性切除32例,其中30例(81.1%)达到R0根治,姑息性切除5例。术后组织病理学分期:Ⅰ期4例(10.8%),Ⅱ期12例(32.4%),Ⅲ期13例(35.1%),Ⅳ期6例(16.2%),2例(5.4%)达到病理完全缓解,Ⅱ期及以下者总例数:Ⅲ/Ⅳ期总例数=18∶19,比例高于化疗前(9∶28),应用χ2检验分析,差异有统计学意义(P<0.05)。在32例进行了根治性切除的病例中,T4 4例(12.5%),T3 13例(40.6%),T2 9例(28.1%),T1 4例(12.5%),Tx 2例(6.3%);N3 2例(6.3%),N2 9例(28.1%),N1 16例(50%),N0 5例(15.6%)。副反应主要为周围神经毒性,56.8%(21/37)出现,其次为手足综合征,40.5%(15/37)出现,均为Ⅰ/Ⅱ级,较轻,可控制。结论 XELOX方案用于局部进展期胃癌新辅助化疗,能降低肿瘤分期,提高根治性切除率,副反应主要表现为周围神经毒性及手足综合征,多较轻,为Ⅰ/Ⅱ级,可控制。[Objective] To analyze the efficacy of XELOX neoadjuvant chemotherapy in locally advanced gastric cancer. [Methods] By statistically analyzing the clinical data of 37 cases treated with XELOX from May 2010 to May 2011. [Results] The efficacy of treatment to each case was well evaluated after two periods of chemotherapy. Among these 37 patients, the percentage of CR was 13.5% （5/37）, PR 37.8% （14/37）, NC 40.5% （15/37）, PD 8.1% （3/37） and RR 51.3% （19/37）. All patients received operational treatments within two or three weeks after chemotherapy, with 32 radical resection cases, 30 of which （81.1%） R0 resected and 5 palliative resection cases. Post-op Histopathologieal Stages： Stage I 10.8% （4/37）, Stage Ⅱ 32.4% （12/37）, Stage llI 35.1% （13/37） and Stage IV 16.2% （6/37）. 2 eases （5.4%） were evaluated as pathological completeremission （PCR）. The ratio of total cases of PCR, Stage I and Stage Ⅱ to Stage Ⅲ/IV was 18 ： 19 post-operatively, much higher than that of pre-chemotherapy, having a statistical difference （P 〈0.05）. Among these 32 cases radical resected, the percentage of T4 was 12.5% （4/32）, T3 40.6% （13/32）,T2 28.1% （9/32）, % 12.5% （4/ 32） and Tx 6.3% （2/32）; N3 6.3% （2/32）, N2 28.1% （9/32）, N, 50% （16/32） and No 15.6% （5/32）. The major side effect was peripheral nerve toxicity, with 56.8% （21/37） patients having similar manifestation, as well as 40.5% （15/37） patients with hand-foot syndrome. Both side effects were of slight degree and controllable. [Conclusions] It showed a good efficacy for XELOX neoadjuvant chemotherapy in locally advanced gastric cancer, with a raised radical resection rate. The major side effects were peripheral nerve toxicity and hand-foot syndrome, both of which were of slight degree and controllable.

关 键 词：局部进展期胃癌 XELOX 新辅助化疗 

分 类 号：R735.2[医药卫生—肿瘤]