摘要
目的：观察和比较HELF方案和HELF／HPLF交替方案对胃差分化腺癌（低分化腺癌、粘液腺癌、印戒细胞癌）根治术后患者无病生存期（DFS）、总生存期（OS）的影响。方法：经组织学证实为低分化腺癌、粘液腺癌及印戒细胞癌的Ⅱ-Ⅲ期胃癌根治术后患者，随机分配至A组（单独HELF方案化疗）或B组（HELF／HPLF方案交替化疗），术后3—5周开始化疗，化疗4—6周期。结果：共入组80例患者，72例可按要求随访及评价不良反应，A组、B组各36例。全组患者共随访7—98月，A组与B组中位随访期差异无统计学意义（30月vs．33月，P=0．383）。A组患者的DFS为4～97月（中位值20月），B组为5～98月（中位值39月），两组差异有统计学意义（P=0．025）。A组的OS为10～97月（中位值28月），B组为7～98月（中位值48月），以B组生存时间更长（P=0．042）。主要不良反应为骨髓抑制及消化道反应，多为Ⅰ-Ⅱ度。结论：HELF方案与HPLF方案交替用于差分化胃腺癌根治术后的辅助治疗，在推迟肿瘤复发转移及延长生存期方面可能优于单用HELF方案。
Purposes：To observe and compare the adjuvant chemotherapy effect of HELF regimen and HELF/HPLF regimen for gastric differencing adenocarcinoma cancer（ poorly differentiated adenocarcinoma, mucinous adenocarcinoma and signet-ring cell carcinoma）. Methods：After undergoing curative resection ,the patients with gastric differencing adenocarcinoma and stage Ⅱ or Ⅲ were randomly assigned to group A （only chemotherapy with HELF regimen） or group B （chemotherapy with HELF or HPLF alternately）. The chemotherapy was performed 3-5 weeks after surgery. The patients were treated for 4-6 cycles. Results： Eighty patients were entered in the study, and 72 patients were estimated（ group A and group B was 36 cases, respectively）. After following up 7-98 months, DFS of group B （ range 5-98 months, median 39 months ） was longer than group A （ range 4-97 months, median 20 months ;P = 0. 025 ） , and OS of group B was longer too （range 7-98 months, median 48 months vs. range 10-97 months, median 28 months;P =0. 042）. The major adverse effects were myelosuppression and digestive tract effect. Conclusion：HELF/HPLF regimen is superior to HELF regimen alone for delaying relapse and metastases in the patients with curativly resected gastric differencing adenocarcinoma cancer.
出处
《临床肿瘤学杂志》
CAS
2007年第9期651-654,658,共5页
Chinese Clinical Oncology
关键词
胃癌
差分化腺癌
辅助化疗
HELF/HPLF方案
Gastric cancer
Differencing adenocarcinoma
Adjuvant chemotherapy
HELF/HPLF regimen
