区域动脉灌注化疗在进展期胃癌短程新辅助化疗中的应用  

Application of regional arterial infusion chemotherapy in short-term neoadjuvant chemotherapy for advanced gastric cancer

作　　者：吴震峰 朱文强 曹勤洪 陈志伟 吴晓宇 陈彻 许哲 李为苏 姚学权 

机构地区：[1]南京中医药大学附属医院(江苏省中医院)消化肿瘤外科,210029

出　　处：《中华胃肠外科杂志》2014年第11期1092-1095,共4页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的 探讨短程新辅助化疗应用于进展期胃癌的可行性,并比较不同化疗方式短程新辅助化疗的临床疗效.方法 回顾性分析2008年1月至201 1年12月间在南京中医药大学附属医院接受短程（1个周期）EOF方案（表柔比星、奥沙利铂、氟尿嘧啶加亚叶酸钙）新辅助化疗的310例进展期胃癌患者的临床资料.比较全身静脉化疗方案与区域动脉灌注化疗方案的临床疗效.结果 310例患者均完成了1个周期的短程EOF方案新辅助化疗,无一例因化疗毒副反应而终止.术后病理缓解率为33.9％（105/310）,其中5例（1.6％）获病理完全缓解.接受区域动脉灌注化疗者的病理缓解率为42.4％（72/170）,明显高于全身静脉化疗者的23.6％ （33/140） （P=0.001）.Logistic多因素回归分析证实,化疗方式是影响进展期胃癌短程新辅助化疗后病理缓解率的独立危险因素（HR=1.827; 95％ CI：1.006～3.316; P=0.048）.结论 进展期胃癌短程新辅助化疗病理缓解率总体较低;区域动脉灌注化疗能提高进展期胃癌短程新辅助化疗的术后病理缓解率。Objective To explore the feasibility of short-term neoadjuvant chemotherapy （NACT） in patients with advanced gastric cancer （AGC）,and to compare clinical efficacy of short-term neoadjuvant chemotherapy with different ways.Methods Clinical data of 310 AGC patients treated with one course of NACT using EOF regimen （epirubicin,oxaliplatin and fluorouracil plus calcium folinate） in our hospital from January 2008 to December 2011 were retrospectively analyzes.Efficacy was compared between regional arterial infusion chemotherapy and intravenously chemotherapy.Results All the 310 AGC patients completed one course of NACT and none was interrupted by adverse events.Postoperative pathological remission rate was 33.9% （105/310） and 5 patients （1.6%） had complete pathological remission.The pathologic response rate in the regional arterial infusion chemotherapy group was higher than that in the intravenously chemotherapy group （42.4% vs.23.6%,P=0.001）.Multivariate analysis revealed that chemotherapy method （HR=1.827,95%CI：1.006-3.316,P=0.048） was associated with significantly higher pathologic response.Conclusions Pathological response rate is quite low following short-term NACT.Regional arterial infusion chemotherapy with short-term NACT can improve the pathological response rate of advanced gastric cancer.

关 键 词：胃肿瘤 新辅助化疗 区域灌注化疗 病理缓解 

分 类 号：R735.2[医药卫生—肿瘤]