摘要
目的:新辅助化疗可以提高进展期胃癌的手术切除率及根治率。本研究旨在评估进展期胃癌行新辅助化疗后的临床疗效。方法:选择2006年9月～2008年9月天津医科大学附属肿瘤医院治疗进展期胃癌患者共80例,分为常规手术组和新辅助化疗+手术组,每组40例。新辅助化疗+手术组患者化疗2个周期,具体方案:奥沙利铂(乐沙定)100mg/m^2 iv d_1(2h),亚叶酸钙400mg/m^2 iv d_1(2h),5-FU 2 400mg/m^2 civ d_1(46h)。每2周为1个周期,共化疗2个周期。化疗后复查CT,了解肿瘤变化后行手术治疗。结果:新辅助化疗+手术组化疗临床有效率(完全缓解+部分缓解)52.5%(21例),疾病稳定37.5%(15例),疾病进展10.0%(4例)。手术总切除率92.5%(37/40),获得根治性切除率77.5%(31/40),剖腹探查率7.5%(3/40)。常规手术组手术总切除率75.0%(30/40),获得根治性切除率52.5%(21/40),剖腹探查率22.5%(9/40)。两组均无手术死亡病例,术后并发症差异无统计学意义。结论:进展期胃癌患者采用改良FOLFOX方案行新辅助化疗具有较高的安全性,并且可以提高手术切除率及根治率以及改善部分患者的临床症状。
Objective： To investigate the efficacy of neoadjuvant chemotherapy with modified FOLFOX regimenfor patients with advanced gastric cancer. Methods： Between September 2006 and September 2008, a total of80 patients with advanced gastric cancer were divided into neoadjuvant chemotherapy＋surgery group （Group A）and surgery alone group （Group B）, with 40 patients in each group. In Group A, we administered neoadjuvantchemotherapy with OXA 100mg/m2 iv d1（2hr）, CF 400mg/m2 iv d1（2hr）, and 5-FU 2 400mg/m2 civ d1（46hr）. After2 treatment cycles, CT was performed in all patients. Results： In Group A, the clinical efficacy （CR＋PR） was 52.5%（21/40）; the SD was 37.5% （15/40）, and PD was 10.0% （4/40）. The overall resectability rate was 92.5% （37/40）;and the curative resection rate was 77.5% （31/40）; only 7.5% （3/40） had exp.lap. In Group B, the overall resectabilityrate was 75.0% （30/40）; the curative resection rate was 52.5% （21/40）; and 22.5% （9/40） had exp.lap.No mortality was observed. No significant differences were found in toxicities between the two groups. Conclusion：Neoadjuvant chemotherapy with modified FOLFOX regimen is safe and effective for patients with advanced gastriccancer and can increase the overall resectability rate and the curative resection rate.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2009年第19期1098-1100,1104,共4页
Chinese Journal of Clinical Oncology
关键词
进展期胃癌
新辅助化疗
手术
Advanced gastric cancer
Neoadjuvant chemotherapy
Surgery
