局部进展期胃癌术后放化疗与单纯化疗疗效观察  

Clinical effect of chemoradiotherapy compared with chemotherapy alone in patients with locally advanced gastric cancer after gastrectomy

作　　者：陶新节 杨林[1] 陈象逊[1] 钱雯川[1] 

机构地区：[1]安徽医科大学第一附属医院放疗科,安徽合肥230022

出　　处：《中华肿瘤防治杂志》2015年第18期1484-1487,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：安徽省教育厅基金(KJ2008A047)

摘　　要：目的比较局部进展期胃癌根治术后放化疗与单纯化疗的疗效及不良反应,为临床选择进展期胃癌术后合适的辅助治疗提供参考。方法收集2006-07-01-2009-01-31安徽医科大学第一附属医院放疗科就诊的胃癌患者66例,按照患者接受的治疗措施分为术后同步放化疗组(33例)和单纯化疗组(33例),观察分析患者1、3、5年生存率及不良反应发生情况。结果同步放化疗组1、3、5年生存率分别为97.0%、87.9%和48.5%,单纯化疗组分别为90.9%、60.6%和33.3%,差异有统计学意义,χ2=5.92,P=0.015;同步放化疗组1、3、5年无瘤生存率分别为78.8%、66.7%和48.5%,单纯化疗组分别为69.7%、45.5%和33.3%,差异有统计学意义,χ2=7.41,P=0.006。Cox回归分析显示,治疗方法、肿瘤部位和肿瘤分期对生存时间有显著影响。≥3级血液学毒性发生率同步放化疗组为15.2%(5/33),单纯化疗组为9.1%(3/33),差异无统计学意义,z=-0.230,P=0.767。≥3级胃肠道反应发生率同步放化疗组为18.2%(6/33),单纯化疗组为12.1%(4/33),差异无统计学意义,z=-0.05,P=0.960。结论局部进展期胃癌术后同步放化疗与单纯化疗相比能提高患者的生存率及无瘤生存率,不良反应能耐受。OBJECTIVE Compared with locally advanced gastric cancer after radical operation on curative effect and adverse reaction of chemoradiotherapy and chemotherapy alone,this study was designed to explore the curative effects of different therapeutic schemes.METHODS Sixty-six patients who were treated in the First Affiliated Hospital of Anhui Medical University from 2006-07-01 to 2009-01-31withⅡ-ⅢB gsatric cancer were included.According to the different therapeutic schemes the patients were divided into postoperative chemoradiotherapy group（n=33）and chemotherapy alone group（n=33）.All patients＇ 1,3,5-year survival and adverse events were observed and analyzed.RESULTS The1,3,and 5-year survival rates for the chemoradiotherapy and chemotherapy group were 97.0%,87.9%,48.5% and90.9%,60.6%,33.3%（χ2=5.92,P=0.015）,respectively,The 1,3,and 5-year recurrence-free survival rates were78.8%,66.7%,48.5%in the chemoradiotherapy group,and 69.7%,45.5%,33.3%in the chemotherapy group（χ2=7.41,P=0.006）.Cox regression analysis showed that treatment methods,tumor location and tumor stage had a significant effect on the survival time.The incidence of grade 3hematological toxicity for the chemoradiotherapy group and chemotherapy group was 15.2%（5/33）vs 9.1%（3/33）（z=-0.230,P=0.767）,and grade 3gastrointestinal toxicity was 18.2%（6/33）vs 12.1%（4/33）（z=-0.05,P=0.960）.CONCLUSION Compared with chemotherapy alone,postoperative chemoradiotherapy can improve survival of locally advanced gastric cancer,its toxic effects are tolerable.

关 键 词：胃肿瘤 同步放化疗 单纯化疗 疗效 

分 类 号：R735.2[医药卫生—肿瘤]