紫杉醇联合顺铂和替加氟新辅助化疗在进展期胃癌中的临床应用  

A clinical study of paclitaxel combined with cisplatin and tegafur as neoadjuvant chemotherapy for advanced gastric cancer

作　　者：崔海滨[1] 葛怀娥[1] 白希永[1] 张维[1] 边青召[1] 

机构地区：[1]河北省沧州市中心医院,061001

出　　处：《山西医药杂志（下半月）》2013年第8期869-871,共3页Shanxi Medical Journal

摘　　要：目的评价紫杉醇联合顺铂、替加氟方案新辅助化疗在治疗进展期胃癌的临床疗效及安全性。方法 41例进展期胃癌患者给予紫杉醇联合顺铂、替加氟方案新辅助化疗(新辅助化疗组),并以同期常规直接手术的52例患者做对照(常规手术组),观察新辅助化疗的毒副作用和所有患者手术的R0切除率、D2的淋巴结清扫率情况及术后1年无病生存率。结果新辅助化疗的有效率为59%(24/41),疾病控制率为93%(38/41)。Ⅲ/Ⅳ度毒副作用主要为白细胞减少及呕吐。新辅助化疗组中34例(83%)行胃癌D2根治术,35例(85%)患者获得R0切除,淋巴结转移率≤30%者33例,淋巴结转移率>30%者8例,1年无病生存率为95%;对照组中,31例(60%)行D2根治术,36例(69%)患者获得R0切除,淋巴结转移率≤30%者28例,淋巴结转移率>30%者24例,1年无病生存率80%。2组1年无病生存率、D2根治术成功率及淋巴结转移率差异均有统计学意义(P<0.05)。2组间R0切除率差异无统计学意义。结论紫杉醇联合顺铂、替加氟方案新辅助化疗患者的耐受性和依从性好,有效率高,并可提高进展期胃癌患者的D2手术切除率、降低淋巴结转移率,并可提高患者1年无病生存率。Objective To evaluate the clinical efficacy and safety of paclitaxel, cisplatin plus tegafur in the treatment of advanced gastric cancer. Methods Forty-one cases of advanced gastric cancer were treated with pacli-taxel and cisplatin, tegafur as three-drug regimen of neoadjuvant chemotherapy （neoadjuvant chemotherapy group）, with 52 cases taking conventional surgery as a control （conventional surgery group）. To observe side effects of neoadjuvant chemotherapy and surgical R0 resection rate, D2 lymph node dissection rate situation and postoperative 1-year disease-free survival in all patients. Results Effective rate of neoadjuvant chemotherapy was 59 % and the disease control rate was 93 %. The Ⅲ/Ⅳ degree of side effects were mainly leukopenia and vomiting. Neoadjuvant chemotherapy group, 34 patients （83 %） for gastric D2 radical mastectomy, 35 patients （85 %） with R0 resection, lymph node metastasis rate ≤30% （33 cases）, lymph node metastasis rate of 〉30% （8 cases）, 1 year disease-free survival rate was 95%; the control group, 31 cases （60%） D2 radical resection, 36 cases （69%） of patients with R0 resection, lymph node metastasis rate ≤ 30% （28 cases）, lymph node metastasis rate 〉30% （24 cases）. The 1-year disease-free survival, the success rate of D2 radical mastectomy and lymph node metastasis rate differences were statistically significant between the two groups （ P 〈0.05）. The two groups R0 resection rate was no statistically significant between the two groups. Conclusion Paclitaxel, cisplatin and tegafur as neo- adjuvant chemotherapy can help patients receive better tolerability and compliance effective rate, improve the D2 resection rate in advanced gastric cancer, lower rate of lymph node metastasis and improve 1-year disease-free sur- vival rate in patients.

关 键 词：胃肿瘤 顺铂 抗肿瘤联合化疗方案 紫杉醇 替加氟 

分 类 号：R473.5[医药卫生—护理学]