新辅助化疗治疗Ⅲ期胃癌的临床疗效观察  

Therapeutic effect of neoadjuvant chemotherapy for stage III gastric carcinoma

作　　者：林赛锋[1] 周磊[1] 葛小刚[1] 樊钊强[1] 郑志强[1] 

机构地区：[1]温州医学院附属第二医院胃肠外科,325027

出　　处：《浙江医学》2012年第12期996-998,共3页Zhejiang Medical Journal

摘　　要：目的 评价新辅助化疗治疗Ⅲ期胃癌的疗效与毒副反应.方法 选取62例经病理证实的胃癌患者,化疗前均经增强多层螺旋CT和超声双重造影评估为Ⅲa、Ⅲb、Ⅲc期,术前给予2~4个疗程的5-氟尿嘧啶＋甲酰四氢叶酸钙＋奥沙利铂＋多西他赛新辅助化疗,3周为1个疗程,每两个周期后进行临床疗效判定,即观察新辅助化疗后肿瘤原发病灶的缓解情况及化疗毒副反应.结果 根据WHO疗效评价标准.新辅助化疗后部分缓解40例,疾病稳定12例,疾病进展10例,临床有效率64.5%;40例获得手术机会,根治手术37例,姑息切除3例,根治性切除率92.5%,37例根治手术患者肿瘤消退分级中TRG4级2例,TRG3级8例,TRG2级20例,TRG1级7例,病理缓解率81.1%.新辅助化疗主要毒副反应为骨髓抑制,其次为胃肠道反应.结论 新辅助化疗在进展期胃癌治疗中近期疗效明显,主要毒副反应为骨髓抑制,临床上应妥善处理.Objective To evaluate the efficacy and safety of neoadjavant chemotherapy in patients with stage III gastric carcinoma. Methods Sixty-two cases of gastric carcinoma with stage III a, III b and III c confirmed by MSCT and DUCS were enrolled in the study. Two to four courses of 5-Fu＋CF＋Oxaliplatin＋Docetaxel regimen were given every three weeks, the clinicN efficacy and toxic effects was evaluated after every two cycles of neoadjvant chemotherapy. Results Forty patients obtained partial responses （64.5%）,12 cases with stable disease,10 cases with progressive disease. Forty patients underwent surgery and radical resection was performed in 37 cases, 3 were received palliative resection. Among 37 cases of radical resection 2 cases had level TRG4,8 cases level TRG3,20 cases level TRG2,7 cases level TRG1, with a pathological efficacy rate of 81.1% The most common toxicities were bone marrow inhibition, followed by nausea and vomiting. Conclusion Neoadjuvant chemotherapy can gain short and intermediate-term efficacy in patients with advanced gastric cancer, and bone marrow inhibition is the main toxicity.

关 键 词：胃肿瘤 新辅助化疗 毒副反应 

分 类 号：R737.9[医药卫生—肿瘤]