新辅助化疗联合术后同步放化疗治疗Ⅲ期胃癌的疗效分析  

Efficacy of neoadjuvant chemotherapy combined with postoperative adjuvant concurrent radiotherapy and chemotherapy for stage Ⅲ advanced gastric cancer

作　　者：崔勇[1] 张荣香[2] 王福立[3] 魏本尊[4] 张建东[5] Yong CUI Rongxiang ZHANG Fuli WANG Benzun WEI Jiandong ZHANG(Department of Oncology, Shouguang People＇s Hospital, Shouguang 262700, China Department of Out-patient, Shouguang People＇s Hospital, Shouguang 262700, China Department of Oncology, Zibo Central Hospital, Zibo 255000, China Department of General Surgery, Zibo Central Hospital, Zibo 255000, China Department of Radiation Oncology, O.ianfoshan Hospital of Shandong University, Ji＇nan 250014, China)

机构地区：[1]寿光市人民医院肿瘤科,山东省寿光市262700 [2]寿光市人民医院门诊部,山东省寿光市262700 [3]淄博市中心医院肿瘤科 [4]淄博市中心医院普外科 [5]山东大学附属千佛山医院放疗科

出　　处：《中国肿瘤临床》2016年第17期747-752,共6页Chinese Journal of Clinical Oncology

基　　金：山东省潍坊市科学技术发展计划项目(编号:2014WS107)资助~~

摘　　要：目的:探讨XELOX(奥沙利铂+卡培他滨)方案新辅助化疗联合术后同步放化疗治疗Ⅲ期进展期胃癌的临床疗效。方法:选取寿光市人民医院、淄博市中心医院和山东大学附属千佛山医院自2010年1月至2013年1月收治的Ⅲ期进展期胃癌患者55例,随机分为治疗组(28例)和对照组(27例)。治疗组给予XELOX方案新辅助化疗,然后行手术,术后给予三维适形放疗同步XELOX方案化疗;对照组先行手术,术后给予同步放化疗。结果:治疗组新辅助化疗后客观有效率为75%。治疗组肿瘤切除率为92.9%,明显高于对照组的81.5%(P=0.049)。治疗组肿瘤根治性切除率为71.4%,明显高于对照组的44.4%(P=0.043)。治疗组淋巴结转移率为48.2%,明显低于对照组的60.2%(P=0.006)。治疗组有1例患者术后病理肿瘤完全消退,9例消退良好,7例中度消退。治疗组和对照组的1、2、3年生存率分别为88.9%vs.69.2%、66.7%vs.46.2%、59.3%vs.38.5%,两组比较差异均具有统计学意义(P=0.037、P=0.045、P=0.049)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:XELOX方案新辅助化疗联合术后同步放化疗可以提高Ⅲ期进展期胃癌患者的肿瘤根治性切除率和术后远期生存率,降低淋巴结转移率。Objective： To investigate the clinical efficacy of neoadjuvant chemotherapy with XELOX （oxaliplatin＋capecitabine） regimen combined with postoperative adjuvant concurrent radiotherapy and chemotherapy for stage Ⅲ advanced gastric cancer. Methods： A total of 55 patients with stageⅢadvanced gastric cancer from Shouguang People＇s Hospital, Zibo Central Hospital, and Shandong Qianfoshan Hospital of Shandong University were enrolled in this study. The patients were randomly divided into the treatment group and the control group. In the treatment group, 28 patients were treated with neoadjuvant chemotherapy with XELOX regimen, underwent surgery, and then received postoperative adjuvant three-dimensional conformal radiotherapy synchronous XELOX regimen. In the control group, 27 cases underwent surgery in advance, and received radiotherapy synchronous XELOX regimen. Results： The objective re- sponse rate of the treatment group was 75%. The tumor resection rate was 92.9%, which was significantly higher than that of the control group at 81.5% （P=0.049）. The tumor radical resection rates in the treatment and control groups were 71.4% and 44.4%, respectively, which are significantly different （P=0.043）. The lymph node metastasis in the treatment group was 48.2%, which was significantly lower than that of the control group at 60.2% （P=0.006）. In the treatment group, one case achieved pathologic complete tumor regression, 9 cases were of good tumor regression, and 7 cases were of moderate tumor regression. The 1-year, 2-year, and 3-year survival rates of the treatment and control groups were 88.9% vs. 69.2%, 66.7% vs. 46.2%, and 59.3% vs. 38.5%, respectively, which are significantly different （P=0.037, P=0.045, and P=0.049）. The results showed no significant difference of incidence of toxicity in the two groups （P〉0.05）. Conclusion： Neoadjuvant chemotherapy with XELOX regimen combined with postoperative adjuvant concurrent chemoradiotherapy for stage III advanced gastric cancer can impr

关 键 词：胃癌 新辅助化疗 放射治疗 奥沙利铂 卡培他滨 

分 类 号：R735.2[医药卫生—肿瘤]