新辅助化疗对进展期胃癌根治术的影响  

Effects of neoadjuvant chemotherapy on advanced gastric cancer before radical gastrectomy

作　　者：吴梅青[1] 周旭坤[2] 李平[3] 罗毅[3] 刘顺顺[3] 李栋[3] 

机构地区：[1]新疆石河子大学医学院,830002 [2] 新疆生产建设兵团医院普外科 [3] 新疆生产建设兵团第一师医院普外科

出　　处：《中华普通外科杂志》2014年第2期98-101,共4页Chinese Journal of General Surgery

基　　金：新疆生产建设兵团科技攻关资助项目

摘　　要：目的 评价新辅助化疗对进展期胃癌根治术的影响及临床疗效.方法 选择2010年1月至2013年1月符合纳入研究条件的进展期胃癌患者,分为新辅助化疗组及对照组,化疗组46例行2周期的FOLFOX方案化疗,化疗有效38例,无效8例,有效者再接受2个周期化疗,46例均在化疗结束后21 d接受腹腔镜胃癌根治术；对照组36例未进行新辅助化疗,直接接受腹腔镜胃癌根治术.82例患者手术均获得成功,术后均再接受4个周期化疗.结果 新辅助化疗后总体有效率为59％.术前化疗组与对照组病理分期无显著差别.两组的手术时间、术中出血量、淋巴结清扫数目相比差异均无统计学意义（均P ＞0.05）.化疗组患者的R0切除率（63％）较对照组（36％）明显增高,复发率及病死率较对照组明显降低.结论 新辅助化疗联合腹腔镜胃癌根治术治疗局部进展期胃癌可明显提高切除率,降低术后复发率及病死率.Objective To evaluate the effect of neoadjuvant chemotherapy on advanced gastric cancer before laparoscopic radical gastrectomy.Methods 46 advanced gastric cancer cases in our hospital from January 2010 to January 2013 were included in experimental group who were given two courses of neoadjuvant chemotherapy with FOLFOX regimen prior to surgery,the responsives （38 cases） received two more courses of neoadjuvant chemotherapy before surgery,and those in whom the chemotherapy was judged as ineffective （8 cases）,received radical gastrectomy 21 days later.As a control,36 diseasematched cases went on upfront surgery without neoadjuvant chemotherapy.All these 82 cases underwent successful laparoscopic gastrectomy.Results The overall effective rate of neoadjuvant chemotherapy was 59%.Before the operation,the differences of pathological staging between the two groups were significantly different; The difference in operation time,the intraoperative blood loss and harvested lymph node number between the experimental group and control group was not statistically different （P 〉 0.05）.The R0 resection rate in experimental group （63%） was higher than in the control group （36%）,P 〈0.05.The recurrence rate and mortality rate in experimental group was lower than that in the control group,P 〈 0.05.Conclusions In advanced gastric carcinoma preoperative neoadjuvant chemotherapy significantly improved the resection rate and reduced postoperative recurrence and mortality rate.

关 键 词：胃肿瘤 化学疗法 辅助 腹腔镜 

分 类 号：R735.2[医药卫生—肿瘤]