新辅助化疗方案用于胃癌根治术临床评价  

Clinical Evaluation of Neoadjuvant Chemotherapy on Patients Undergoing Radical Gastrectomy

作　　者：姚嗣会 卢业才[2] 唐维平[2] YAO Sihui;LU Yecai;TANG Weiping(Surgical DepartmentⅠ,Lujiang County Hospital of TCM,Hefei,Anhui,China 231500;Department of Gastrointestinal Surgery,Chaohu Hospital,Anhui Medical University,Chaohu,Anhui,China 238000)

机构地区：[1]安徽省合肥市庐江县中医院外一科,安徽合肥231500 [2]安徽医科大学附属巢湖医院胃肠外科,安徽巢湖238000

出　　处：《中国药业》2022年第6期95-97,共3页China Pharmaceuticals

基　　金：安徽省自然科学基金[1808085MH182]。

摘　　要：目的探讨新辅助化学治疗(简称化疗)方案对胃癌根治术患者手术切除率及预后的影响。方法选取庐江县中医院2017年8月至2020年8月收治的胃癌患者84例,按是否进行新辅助(术前)化疗分为研究组(33例)和对照组(51例)。两组患者均采用胃癌根治术联合D2淋巴清扫术治疗,术后予8周期常规辅助化疗。研究组患者术前持续予多西他赛+奥沙利铂+卡培他滨行新辅助化疗方案2个疗程(21 d为1个疗程),化疗结束后1周手术。结果研究组患者的手术时间明显短于对照组,术中出血量和术后引流量均明显少于对照组(P<0.05),两组拆线时间无明显差异(P>0.05);研究组患者手术切除、根治性切除率均明显高于对照组(90.91%比70.59%,87.88%比66.67%,P<0.05);研究组患者近期疗效优于对照组,但组间无明显差异(P>0.05);两组患者1年生存率比较无明显差异(P>0.05),研究组患者2年生存率明显高于对照组,复发率和转移率明显低于对照组(P<0.05);两组不良反应发生率无明显差异(P>0.05)。结论多西他赛+奥沙利铂+卡培他滨的新辅助化疗方案,可降低胃癌根治术手术风险,提高手术切除率,改善近、远期疗效。Objective To investigate the effect of neoadjuvant chemotherapy on resection rate and prognosis of patients undergoing radical gastrectomy.Methods A total of 84 patients with gastric cancer admitted to Lujiang County Hospital of TCM from August 2017 to August 2020 were selected and divided into the study group(n=33)and the control group(n=51)according to whether neoadjuvant chemotherapy was performed.Both groups were treated with radical gastrectomy combined with D2 lymphadenectomy,eight cycles of conventional adjuvant chemotherapy were given after surgery.While the study group was treated with neoadjuvant chemotherapy regimen of docetaxel+oxaliplatin+capecitabine for 2 courses(21 d for 1 course)before surgery,and surgery was performed 1 week after chemotherapy.Results The operation time of the study group was significantly shorter than that of the control group,the amount of bleeding during operation and the amount of drainage after surgery were both less than those of the control group(P<0.05),and there was no significant difference in suture removal time between the two groups(P>0.05).The surgical resection rate and radical resection rate in the study group were significantly higher than those in the control group(90.91%vs.70.59%,87.88%vs.66.67%,P<0.05).The short-term curative effect of the study group was better than that of the control group,but there was no significant difference between the two groups(P>0.05).There was no significant difference in 1-year survival rate between the two groups(P>0.05).The 2-year survival rate of the study group was significantly higher than that of the control group,while the recurrence rate and metastasis rate were significantly lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Neoadjuvant chemotherapy regimen of docetaxel+oxaliplatin+capecitabine can reduce the risk of operation,increase the resection rate and improve the short-term and long-term curative effect.

关 键 词：多西他赛 奥沙利铂 卡培他滨 新辅助化疗 胃癌根治术 手术切除率 预后 

分 类 号：R969.4[医药卫生—药理学] R979.1[医药卫生—药学]