DCS方案新辅助化疗治疗Ⅲ期胃癌64例近期疗效的临床研究  

Clinical efficacy research of DCS neoadjuvant chemotherapy for stage Ⅲ gastric cancer

作　　者：汪龙庆[1] 高波[1] 王世宇[1] 李新海[2] 

机构地区：[1]辽宁省抚顺矿务局总医院肿瘤外科,辽宁抚顺113008 [2]辽宁省抚顺矿务局总医院影像中心,辽宁抚顺113008

出　　处：《中国现代普通外科进展》2015年第1期34-38,共5页Chinese Journal of Current Advances in General Surgery

摘　　要：目的：总结DCS方案新辅助化疗治疗Ⅲ期胃癌近期疗效。方法 ：Ⅲ期胃癌64例随机分为新辅助＋手术组（22例）和手术组（42例）。两组根据具体情况采取根治性切除、姑息性切除及探查术。新辅助＋手术组术前采用DCS方案化疗,观察两组疗效和手术R0切除率。结果：新辅助＋手术组患者均完成了3-4个周期的化疗,总有效率77.3%。R0切除率新辅助＋手术组（72.7%）明显高于手术组（57.1%）（P〈0.05）。两组在手术时间、术中出血量、术后引流、术后胃肠功能恢复时间及并发症等方面差异无统计学意义。手术清扫淋巴结及淋巴结转移数方面,手术组明显多于新辅助＋手术组（P〈0.05）。两组的复发转移率及总生存率差异具有统计学意义（P=0.035）。结论：DCS方案对Ⅲ期胃癌患者进行新辅助化疗,能够显著缓解临床症状,提高手术切除及R0切除率,化疗的不良反应属可耐受范围,未增加手术并发症及手术费用,能够降低术后复发转移率,但在淋巴结摘取数和转移淋巴结数方面不如手术组。Objective： Summary DCS neoadjuvant chemotherapy for stage Ⅲ gastric term effect. Methods： Since April 2012—2013 in August, the General Hospital of Fushun Mining Bureau completed a total of Surgical Oncology Ⅲ 64 cases of gastric cancer were randomly divided into neoadjuvant ＋ surgery group and surgery group, 22 cases in which neoadjuvant ＋ surgery group,surgery group 42 cases. Recent analysis of the efficacy of the two groups. Statistical analysis was performed using SPSS14.0 software. Count data using χ2 test, measurement data using t test toP〈0.05 was considered statistically significant. Result： 64 cases of stage Ⅲ gastric cancer neoadjuvant ＋ surgery patients were completed 3-4 cycles of chemotherapy, complete remission four cases（18.2%）, partial remission in 13 cases（59.1%）, stable disease（9.1%）, 2 cases of disease Advances in 3 cases（13.6%）, the total efficiency of 17 cases（77.3%）. In terms of surgical resection, R0 resection rates were： neoadjuvant ＋ surgery group（72.7%）was significantly higher than the surgery group（57.1%）, the difference was statistically significant（P〈0.05）. The two groups in operative time,blood loss difference in terms of postoperative drainage, postoperative gastrointestinal function recovery time and complications there was no statistical significance. But in the lymph nodes and lymph node surgery in several areas, surgery group was significantly greater than neoadjuvant ＋ surgery group（P〈0.05）. Recurrence rate and overall survival between the two groups was statistically significant difference（P=0.035）. Conclusion： DCS program Ⅲ gastric cancer patients with neoadjuvant chemotherapy, the tumor can significantly alleviate and improve surgical resection and R0 resection,adverse effects of chemotherapy is tolerable range, did not increase surgical complications and surgical costs, to improve postoperative recurrence and metastasis, but the number of lymph nodes and lymph node removal in several areas declined.

关 键 词：外科手术 胃肿瘤 新辅助化疗 

分 类 号：R735.2[医药卫生—肿瘤] R730.53[医药卫生—临床医学]