局部进展期食管胃结合部腺癌围手术期化疗疗效研究  

Efficacy of perioperative chemotherapy for locally advanced adenocarcinoma of esophagogastric junction

作　　者：夏甘树 刘志强[1] 李守淼[1] 万云杰[1] 龚艳鑫 李保中[1] XIA gan-shu;LIU zhi-qiang;LI shou-miao;WAN yun-jie;GONG Yan-xin;LI Bao-zhong(Department of General Surgery Ward1,Anyang Tumor Hospital of Henan Province,Anyang455000,China)

机构地区：[1]安阳市肿瘤医院普通外科一病区,河南安阳455000

出　　处：《中华肿瘤防治杂志》2022年第21期1563-1567,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：“十三五”国家科技重大项目子课题(2018ZX10303502-001);河南省医学科技攻关计划省部共建项目(SBGJ202002129)。

摘　　要：目的探讨局部进展期可手术食管胃结合部腺癌(AEG)患者采用替吉奥联合奥沙利铂(SOX)方案围手术期化疗的手术并发症及生存情况。方法回顾性分析2017-03-14-2020-01-17安阳市肿瘤医院外科初治局部进展期可手术AEG患者63例临床资料。根据不同治疗方式将患者分为观察组(围手术期化疗组)和对照组(辅助化疗组)。观察组:SOX方案术前新辅助化疗+行根治手术+术后辅助化疗,共6个周期;对照组:行根治手术+SOX方案术后辅助化疗6个周期。观察2组患者手术并发症及生存情况。结果15例对照组患者均达到R0切除并接受术后辅助化疗。48例观察组患者中,有41例接受手术切除治疗(39例达到R0切除,2例R1切除);有7例因新辅助化疗期间肿瘤进展、患者拒绝手术或无法根治行探查手术退出实验。39例R0切除患者中,有28例接受术前新辅助化疗及术后辅助化疗,纳入生存分析;11例仅行术前新辅助化疗。2例R1切除患者更换术后治疗方案。2组R0切除率差异无统计学意义,P=1.000。生存分析结果显示,观察组的2年无病生存率(DFS;64.3%)和总生存率(OS;85.7%)均高于对照组(50.0%和64.3%),差异无统计学意义,χ2值分别为0.791和1.432,P值分别为0.374和0.133。在手术并发症方面,观察组发生8例手术并发症,对照组3例,2组比较差异均无统计学意义,P=1.000。结论在局部进展期AEG患者选择SOX方案围手术期化疗,手术期间具有较好安全性,可能优于辅助化疗方式,提高患者生存时间。Objective To observe surgical complications and survival of SOX regimen in perioperative chemotherapy for patients with locally advanced operable adenocarcinoma of esophagogastric junction(AEG).Methods From March 14,2017 to January 17,2020,a total of 63patients diagnosed with operable locally advanced AEG were selected in Department of General Surgery of Anyang Tumor Hospital and retrospectively analyzed.Patients were divided into observation group and control group based on different treatment regimens.Patients in observation group or perioperative chemotherapy group were given SOX regimen,including neoadjuvant chemotherapy plus radical operation and adjuvant chemotherapy.Patients in control group or adjuvant chemotherapy group were given radical operation and SOX regimen adjuvant chemotherapy.Both groups received treatment for six cycles and observed their surgical complications and survival.Results A total of 15 patients in the control group underwent R0resection and received postoperative adjuvant chemotherapy.Forty-one patients of 48patients in observation group underwent operation,among whom 39patients achieved R0resection(95.1%),two patients R1resection,and seven patients dropped out of the experiment owing to tumor progression during neoadjuvant chemotherapy,surgery refusal and exploratory operation.Among 39patients with R0resection,28patients who received preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy were included in the survival analysis;and 11patients received only preoperative neoadjuvant chemotherapy,and two patients with R1resection changed postoperative treatment protocols.There was no significant difference in R0resection rate between the two groups(P=1.000).Survival analysis showed that the 2-year disease-free survival(DFS)and 2-year overall survival(OS)achieved 64.3%and 85.7%,respectively in perioperative chemotherapy group,while 50%and 64.3%in adjuvant chemotherapy group.The 2-year DFS and 2-year OS of perioperative chemotherapy group were higher than those of ad

关 键 词：食管胃结合部腺癌 围手术期化疗 无疾病生存 手术后并发症 奥沙利铂 替吉奥 

分 类 号：R735.2[医药卫生—肿瘤]