进展期胃癌术后三维适形放疗同步紫杉醇＋替吉奥方案化疗的临床研究  

conformai radiotherapy concurrent with paclitaxel and TS-1 chemotherapy in the treatment of advanced gastric carcinoma

作　　者：蒋雪超[1] 贾立娟[1] 崔洪霞[1] 郭滨[1] 王新波[1] 

机构地区：[1]山东省滨州市中心医院肿瘤科,251700

出　　处：《中国医师进修杂志》2013年第11期12-15,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨三维适形放疗同步紫杉醇＋替吉奥方案化疗治疗进展期胃癌术后患者的临床疗效。方法将60例进展期胃癌术后患者按入院时间随机分为治疗组和对照组，每组30例。治疗组给予三维适形放疗同步紫杉醇＋替吉奥方案化疗，对照组给予紫杉醇＋替吉奥方案化疗。观察两组患者的远期生存率、局部复发率及不良反应。结果治疗组与对照组的1年生存率分别为93．1％（27129）和72.4％（21／29），2年生存率分别为75．9％（22129）和48.3％（14／29），治疗组与对照组的1年复发率分别为6．9％（2，29）和31．0％（9／29），2年复发率分别为13．8％（4／29）和44．8％（13／29），两组的1年和2年生存率、1年和2年复发率比较差异均有统计学意义（P〈0．05或〈0．01）。两组不良反应主要表现为白细胞下降、血小板下降、贫血、恶心、呕吐、肝功能损害和口腔黏膜炎。其中治疗组恶心、呕吐的发生率明显高于对照组[83．3％（25／30）比53．3％（16／30）]，差异有统计学意义（P=0．012）。结论三维适形放疗同步紫杉醇＋替吉奥方案化疗可提高进展期胃癌术后患者的远期生存率，降低局部复发率，但胃肠道不良反应有所增加。Objective To investigate the clinical eflqcacy of postoperative three-dimensional conformal radiotherapy concurrent with paclitaxel ＋TS-1 chemotherapy in the treatment of advanced gastric carcinoma. Methods A total of 60 patients with advanced gastric carcinoma were randomly divided into treatment group and control group. In treatment group, 30 patients received simultaneous three-dimensional conformal radiations therapy combined with paclitaxel ＋TS-1 chemotherapy. In control group, 30 patients received paclitaxel ＋TS-1 chemotherapy. The long term survival rate, local recurrence rate and side reactions were observed in two groups. Results The 1,2-year survival rate in treatment group [ 93.1% （27/29）, 75.9%（22/29）] and control group [72.4% （21/29）,48.3% （14/29）] had significant difference （P〈 0.05）. The 1,2-year local recurrence rate in treatment group [6.9% （2/29）, 13.8% （4/29）] and control group [ 31.0% （9/29）, 44.8% （ 13/29 ） ] had significant difference （P 〈 0.05 or 〈 0.01 ）. The side reactions in two groups were mainly manifested as leukopenia, thrombocytopenia, anemia, nausea, vomiting, liver function damage and oral mucositis. The incidence rate of nausea, vomiting in treatment group was significantly higher than that in control group [ 83.3%（25/30） vs. 53.3%（16/30） ] （P = 0.012）. Conclusions Postoperative three- dimensional conformal radiotherapy concurrent with paclitaxel ＋TS-1 chemotherapy in the treatment ofadvanced gastric carcinoma may improve the long-term survival rate, lower local recurrence rate. But the adverse reactions are increased.

关 键 词：胃肿瘤 放射疗法 计算机辅助 紫杉醇 替吉奥 

分 类 号：R735.2[医药卫生—肿瘤]