110例胃癌综合治疗后失败模式分析  

Analysis of the failure pattern in 110 patients with radical resection of gastric cancer

作　　者：曾海[1] 张为家[1] 李爽[1] 

机构地区：[1]湖北省荆州市第一人民医院肿瘤科,434000

出　　处：《国际肿瘤学杂志》2015年第2期91-94,共4页Journal of International Oncology

摘　　要：目的分析胃癌根治术及辅助治疗后的失败模式及生存情况，为胃癌综合治疗策略提供参考。方法收集接受胃癌根治术及术后辅助治疗的病例110例，统计5年内各种失败模式的病例数。采用KaplanMeier法计算术后生存率，卡方检验判断分化程度、肿瘤部位、性别等因素对生存率的影响。结果全组110例病例的1、3、5年生存率分别为83.64%（92/110）、46.36%（51/110）、35.45%（39/110）。治疗失败的原因主要为出现恶性腹腔积液，占失败原因的41.51%（22/53），腹腔淋巴结转移占30.19%（16/53），吻合口复发占13.21%（7/53），腹壁种植或肠系膜转移占9.43%（5/53），实质脏器转移占5.66%（3/53）。术后单纯化疗组5年内局部失败率为22.22%（20/90），术后同步放化疗组为15.00%（3/20）。术后单纯化疗组与术后同步放化疗组的1年生存率分别为84.44%、80.00%，差异无统计学意义（χ^2=0.236，P=0.627）；3年生存率分别为66.67%、40.00%（χ^2=4.930，P=0.026），5年生存率分别为53.33%、20.00%（χ^2=7.294，P=0.007），前者显著高于后者。结论腹膜转移为目前胃癌根治术及术后辅助放化疗的最主要失败模式。胃癌术后放化疗较单纯化疗降低了局部复发率，但未能延长生存时间。ObjectiveTo find the reasonable treatment strategy by analyzing the failure pattern and survival rates of radical resection of gastric cancer. MethodsData were collected from 110 patients with radical resection and adjuvant treatment of gastric cancer, counted up the number of cases that failure in different ways. The survival rate after operation was calculated by KaplanMeier. The chisquare test was used to find the differences in survival rates between different differentiation, location and gender. Results1, 3, 5year survival rates of 110 cases were 83.64% （92/110）, 46.36% （51/110）, 35.45% （39/110）, respectively. Malignant ascites was the main failure type for postoperative of gastric cancer, approximately accounting for 41.51% （22/53）, abdominal lymph node metastasis accounting for 30.19% （16/53）, anastomotic recurrence accounting for 13.21% （7/53）, abdominal implantation and mesenteric metastasis accounting for 9.43% （5/53）, organ metastasis accounting for 5.66% （3/53）. The 5year local failure rate of concurrent chemoradiotherapy group was a little lower than that in adjuvant chemotherapy alone group （15.00%∶22.22%）. The 1year survival rates of adjuvant chemotherapy alone and concurrent chemoradiotherapy group were 84.44% and 80.00% respectively, with no significant difference （χ^2=0.236, P=0.627）. However, the 3, 5year survival rates of the two groups were 66.67% vs 40.00% and 53.33% vs 20.00% respectively, with statistically significant differences （χ^2=4.930, P=0.026; χ^2=7.294, P=0.007）. Conclusion Peritoneal metastasis is the most common failure pattern for the patients with gastric cancer who received radical operation and adjuvant treatment. The relapse rate of concurrent chemoradiotherapy group is lower than that in adjuvant chemotherapy alone group, but the overall survival rate is similar.

关 键 词：胃肿瘤 肿瘤辅助疗法 放射疗法 药物疗法 

分 类 号：R735.2[医药卫生—肿瘤]