真实世界局部晚期胃癌新辅助化疗的疗效及安全性  

Efficacy and safety of real world neoadjuvant chemotherapy for locally advanced gastric cancer

作　　者：赵浩森 曲颜丽[1] ZHAO Haosen;QU Yani(Department of Gastroenterology,Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,China)

机构地区：[1]新疆医科大学附属肿瘤医院消化内科,新疆乌鲁木齐830000

出　　处：《中国现代医生》2024年第34期24-28,57,共6页China Modern Doctor

摘　　要：目的探讨局部晚期胃/胃食管结合部腺癌患者两药/三药新辅助化疗(neoadjuvant chemotherapy,NACT)的疗效及安全性。方法选取2016年1月至2021年12月新疆医科大学附属肿瘤医院收治的112例局部晚期胃/胃食管结合部腺癌患者为研究对象,根据患者的NACT方案将其分为两药组(36例)和三药组(76例)。所有患者均行至少2个周期的NACT,之后接受手术治疗。比较两组患者的治疗疗效、无病生存期(disease-freesurvival,DFS)和总生存(overallsurvival,OS)。结果三药组患者的部分缓解占比显著高于两药组(P<0.05)。两组患者的OS、DFS、R0切除率、肿瘤降级比较差异均无统计学意义(P>0.05);多因素Cox回归分析结果显示,手术方法、病理分化类型、术后肿瘤病理分期、神经侵犯均是影响患者OS的独立危险因素(P<0.05),年龄、手术方法、术后肿瘤病理分期均是影响患者DFS的独立危险因素(P<0.05)。三药组患者的严重贫血比例显著高于两药组(P<0.05),其余不良反应两组间比较差异均无统计学意义(P>0.05)。结论两药/三药NACT方案对患者的远期预后无显著影响,但患者的年龄、术后肿瘤病理分期、病理分化类型对患者的预后有一定影响。Objective To investigate the efficacy and safety of two-drug/three-drug neoadjuvant chemotherapy(NACT)for patients with locally advanced gastric/gastroesophageal junction adenocarcinoma.Methods A total of 112 patients with locally advanced gastric/gastroesophageal junction adenocarcinoma admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from January 2016 to December 2021 were selected as study objects,and were divided into two-drug group(36 cases)and three-drug group(76 cases)according to the NACT regimen.All patients underwent at least 2 cycles of NACT followed by surgery.The therapeutic effect,disease-free survival(DFS)and overall survival(OS)were compared between two groups.Results The proportion of partial response in three-drug group was significantly higher than that in two-drug group(P<0.05).There were no significant differences in OS,DFS,R0 resection rate and tumor degradation between two-drug and three-drug groups(P>0.05).Multivariate Cox regression analysis showed that surgical method,pathological differentiation type,pathological stage of postoperative tumor,and nerve invasion were independent risk factors for OS(P<0.05),age,surgical method and pathological stage of postoperative tumor were independent risk factors for DFS(P<0.05).The proportion of severe anemia in three-drug group was significantly higher than that in two-drug group(P<0.05),and there were no significant differences in other adverse reactions between two groups(P>0.05).Conclusion The two-drug/three-drug NACT regimen have no significant effect on the long-term prognosis of patients,but the patient’s age,pathological stage of postoperative tumor and pathological differentiation type have certain effects on the prognosis of patients.

关 键 词：局部晚期胃癌 新辅助化疗 肿瘤降级 

分 类 号：R735.2[医药卫生—肿瘤]