胃癌伴幽门梗阻患者新辅助化疗的近期疗效分析  

An analysis of short-term efficacy of neoadjuvant chemotherapy for gastric cancer patients complicated with pyloric obstruction

作　　者：朱淼 吴震峰 曹勤洪 李为苏 姚学权 刘福坤 许哲 

机构地区：[1]南京中医药大学附属医院消化肿瘤外科,江苏省210029

出　　处：《江苏医药》2017年第15期1096-1099,共4页Jiangsu Medical Journal

摘　　要：目的探讨新辅助化疗(NACT)在胃癌伴幽门梗阻患者中的近期治疗效果。方法将72例接受NACT的胃癌伴幽门梗阻患者分为区域动脉灌注化疗组(A组,38例)和全身静脉化疗组(B组,34例),比较两组患者NACT后的近期疗效。结果两组无因化疗不良反应而停止化疗的病例,亦未出现化疗相关死亡者。A、B组肿瘤根治性切除率和术后并发症发生率比较无统计学差异(94.7%vs.94.1%和5.3%vs.5.9%)(P>0.05);但与B组相比,A组梗阻缓解时间和恢复流质时间缩短(3dvs.6d和6dvs.9d)(P<0.01),术后病理缓解率提高(52.6%vs.23.5%)(P<0.05)。结论胃癌伴幽门梗阻患者采用营养支持联合NACT的耐受性好。与全身静脉化疗相比,区域动脉灌注化疗能改善胃癌伴幽门梗阻患者的梗阻症状,提高术后病理缓解率。Objective To investigate the short-term clinical efficacy of neoadjuvant chemotherapy（NACT）for gastric cancer patients complicated with pyloric obstruction.Methods A total of 72 gastric cancer patients complicated with pyloric obstruction underwent NACT was randomly divided into two groups of A（received regional arterial infusion chemotherapy plus nutrition supports,38 cases）and B（received intravenously chemotherapy plus nutrition supports,34 cases）.The short-term efficacy was compared between two groups.Results No patients stopped the chemotherapy as the result of adverse effects,and no chemotherapy-related deaths occurred.There were no significant differences in the rates of radical resection and postoperative complications between groups of A and B（94.7%vs.94.1%and 5.3%vs.5.9%）（P〉0.05）.But compared with group B,the times of obstruction remission and oral intake were shortened（3d vs.6d and 6d vs.9d）（P〈0.01）,and the rate of postoperative pathologic response was increased in group A（52.6%vs.23.5%）（P〈0.05）.Conclusion NACT plus nutrition supports are safe and well-tolerated for gastric cancer patients complicated with pyloric obstruction.Compared with intravenous chemotherapy,regional arterial infusion chemotherapy results in a more rapid improvement of oral intake and a higher rate of pathological response in gastric cancer patients complicated with pyloric obstruction.

关 键 词：胃癌 幽门梗阻 新辅助化疗 区域灌注化疗 

分 类 号：R735[医药卫生—肿瘤]