术前化疗对晚期胃癌患者R0切除的影响  

The relationship between preoperative chemotherapy and R0 resection in patients with advanced gastric cancer

作　　者：胡时栋[1] 邹贵军[1] 邹振玉[1] 胡子龙[1] 吴有军[1] 邢晓伟[1] 李宇轩[1] 张凯[1] 何长征[1] 王迪[1] 杜晓辉[1] HU Shidong ZOU Guijun ZO U Zhenyu et al(Department of General Surgery, Chinese People＇s Liberation Army General Hospital, Beijing 100853, China)

机构地区：[1]中国人民解放军总医院普通外科,北京100853

出　　处：《临床外科杂志》2017年第2期131-134,共4页Journal of Clinical Surgery

基　　金：国家自然科学基金资助项目(61170123)

摘　　要：目的探讨多西他赛联合奥沙利铂,替吉奥化疗方案用于晚期胃癌转化治疗的有效性。方法56例晚期胃癌患者,28例采取术前多西他赛联合奥沙利铂,替吉奥的转化治疗方案;28例直接进行手术。使用单因素及多因素统计学方法分析两组患者的临床病理特征(年龄,性别,T,N,M分期,临床分期,大体分型,组织学分型,分化程度)及R0切除率。结果术前化疗组和直接手术组患者的年龄[(55.82±12.80)岁比(61.54±11.30)岁],性别[(男19例,女9例)比(男23例,女5例)],T分期[(T3 11例,T4 17例)比(T3 7例,T4 21例)],N分期[(N1 25例,N2 3例)比(N1 26例,N2 2例)],M分期[(M0 3例,M0 25例)比(M0 1例,M1 27例)],临床分期[(Ⅲ期3例,Ⅳ期25例)比(Ⅲ期1例,Ⅳ期27例)],大体分型[(溃疡型26例,隆起型2例)比(溃疡型22例,隆起型6例)],组织学分型[(腺癌24例,印戒细胞癌4例)比(腺癌27例,印戒细胞癌1例)],分化程度[(中分化5例,低分化23例)比(中分化8例,低分化28例)]比较,差异均无统计学意义(P>0.05);R0切除率两组比较,差异有统计学意义(53.6%vs 10.7%,P=0.001),单因素及多因素Logistic回归显示术前化疗有助于提高晚期胃癌患者R0切除率(OR:9.615,95%CI:2.349~39.351,P=0.002)。结论多西他赛联合奥沙利铂,替吉奥术前化疗方案提高了晚期胃癌患者的R0切除率。Objective To observe the efficacy of docetaxel, oxaliplatin plus S-1 regimen as the preoperative chemotherapy for advanced gastric cancer patients. Methods Clinical data of 56 patients with advanced gastric cancer who were treated with surgery in Chinese People＇s Liberation Army General Hospital from September 2013 to December 2015 were retrospectively analyzed. 28 patients were given do- cetaxel,oxaliplatin plus S-1 regimen as the preoperative chemotherapy and 28 patients were given surgery alone. Univariate and multivariate analyses were carried out to investigate the difference in clinicopatholog- ical characteristics （ Age, Gender, T classification, N classification, M classification, Stage, Macroscopic classification,Histological classification, Differentiation） and R0 resection rate between the two group pa- tients. Results There were statistics difference in R0 resection rate between the two groups （53.6% vs 10.7% ,P =0.001） ,while not in age（55.82 ± 12.8 vs 61.54 ± 11.3） ,gender（Male： 19,Female：9 vs Male ： 23, Female ： 5 ）, T classification （ T3 ： 11, T4 ： 17 vs T3 ： 7, T4 ： 21 ） , N classification （ N 1 ： 25, N2 ： 3 vs N 1：26, N2 ： 2）, M classification （ M0 ： 3, M0：25 vs M0 ： 1 M 1：27）, Clinical Stage （ ~[ ： 3, IV ： 25 vs 11I ： 1 ： 1, IV ：27 ）, Macroscopic classification （ Ulcerative type ： 26, Protruding type ： 2 vs Ulcerative type ： 22, Pro- truding type ：6 ）, Histological classification （ Adenocarcinoma ： 24, Signet-ring cell carcinoma ：4 vs Adeno- carcinoma ：27, Signet-ring cell carcinoma： 1 ）, Differentiation （ Moderately ： 5, Poorly： 23 vs Moderately： 8, Poorly ：28 ） （P 〉 0.05 ） ; Univariate and multivariate logistic regression analyses revealed that preoperative chemotherapy helped to improve R0 resection inpatients with advanced gastric cancer （OR：9. 615,95% CI：2.349 -39.351 ,P=0.002）. Conclusion Docetaxel,oxaliplatin plus S-1 regimen as thepreoperative chemotheraov incr

关 键 词：晚期胃癌 术前化疗 RO切除率 多西他赛 

分 类 号：R735.2[医药卫生—肿瘤]