FLOT方案新辅助化疗联合腹腔镜D2根治术在局部进展期胃癌中的应用及预后价值分析  

Application and prognostic value of FLOT neoadjuvant chemotherapy combined with laparoscopic D2 radical resection in patients with locally advanced gastric cancer

作　　者：许雪飞[1] XU Xue-fei(Department of General Surgery,Suzhou Xiangcheng People’s Hospital,Suzhou 215131,Jiangsu,China)

机构地区：[1]苏州市相城人民医院普外科,苏州215131

出　　处：《中国临床医学》2020年第6期988-991,共4页Chinese Journal of Clinical Medicine

基　　金：苏州市科技发展计划项目(SS201852).

摘　　要：目的:探讨FLOT方案新辅助化疗联合腹腔镜D2根治术对局部进展期胃癌的治疗效果及预后价值。方法:回顾性分析2015年1月至2017年12月苏州市相城人民医院普外科收治的86例局部进展期胃癌患者的病例资料,分为FLOT方案新辅助化疗+腹腔镜D2手术组(联合治疗组,n=43)和单纯腹腔镜D2手术组(单纯手术组,n=43)。评估2组临床资料、疗效和不良反应,比较2组患者的生存差异。结果:2组患者临床资料、不良反应发生率差异无统计学意义。联合治疗组R0切除率高于单纯手术组(χ^2=5.108,P=0.024);联合治疗组术后T1+T2分期、N0+N1分期高于单纯手术组(χ^2=5.677,P=0.017;χ^2=10.488,P=0.001)。中位随访时间为54个月,联合治疗组的中位OS为51个月,单纯手术组的中位OS为33个月,联合治疗组更有生存优势(χ^2=4.306,P=0.038)。结论:在局部进展期胃癌中,FLOT方案新辅助化疗联合腹腔镜D2根治术可提高R0切除率,降低肿瘤分期,延长总生存期,有临床应用推广价值。Objective:To explore the therapeutic effect and prognostic value of FLOT neoadjuvant chemotherapy combined with laparoscopic D2 radical operation in patients with locally advanced gastric cancer.Methods:A total of 86 patients with locally advanced gastric cancer were retrospectively analyzed in the Department of General Surgery,Suzhou Xiangcheng People’s Hospital from January 2015 to December 2017,including 43 cases of FLOT neoadjuvant chemotherapy+laparoscopic D2 operation(combined treatment group)and 43 cases of laparoscopic D2 operation(simple operation group).The general clinical data,efficacy,adverse reactions,and survival of the two groups were compared.Results:There were no significant differences in general clinical data between the two groups.The removal rate of R 0 in the combined treatment group was higher than that in the simple operation group(χ^2=5.108,P=0.024).The number of patients in T 1+T 2 and N 0+N 1 stages after operation in the combined treatment group was greater than that in the simple operation group(χ^2=5.677,P=0.017;χ^2=10.488,P=0.001).There was no significant difference in the incidence of adverse reactions between the two groups.The median follow-up time of 86 patients was 54 months.The median OS was 51 months in the combined treatment group and 33 months in the simple operation group.Kaplan-Meier survival analysis suggests that the combined treatment group has significant survival advantage.Conclusion:FLOT neoadjuvant chemotherapy combined with laparoscopic D2 radical operation can improve R 0 resection rate,reduce tumor stage,and improve the prognosis of patients,which has clinical application and promotion value.

关 键 词：新辅助化疗 腹腔镜手术 进展期胃癌 预后 

分 类 号：R735.2[医药卫生—肿瘤]