摘要
目的探讨替吉奥+奥沙利铂(SOX)新辅助化疗联合胃癌根治Ⅰ+式(D1+)手术治疗进展期老年胃癌的有效性、安全性。方法回顾性收集2013年1月-2015年12月我院收治的年龄≥60岁的老年进展期胃癌患者病历和随访资料,筛选出64例实施SOX新辅助化疗联合D1+手术治疗的老年胃癌患者,再随机筛选匹配64例在同一时间内直接实施胃癌标准根治Ⅱ式(D2)手术老年胃癌患者进行对照研究。结果两组患者的基线水平一致,SOX新辅助化疗方案的疾病控制率和化疗有效率分别为98.44%和70.31%,3、4级血液系统和非血液系统不良反应率均为6.25%,SOX新辅助化疗联合D1+手术较标准D2手术平均手术时间短[(206.72±50.29)min vs(225.81±50.75)min,t=1.913,P=0.034]、术后重症监护时间短[(21.23±3.56)h vs(33.97±4.43)h,t=3.355,P=0.044]、术中出血量较少[(241.41±48.99)ml vs(290.63±41.95)ml,t=2.138,P=0.048]、手术相关并发症发生率低(9.38%vs 21.88%,χ~2=3.793,P=0.048);SOX新辅助化疗联合D1+手术组相较标准D2手术组中位生存时间稍长,但差异无统计学意义(23个月vs 19个月,χ~2=0.314,P=0.575)。结论 SOX新辅助化疗联合D1+手术治疗老年进展期胃癌术后并发症发生率低,疗效与标准D2手术相当。
Objective To investigate the effectiveness and safety of SOX regimen combined with DI＋ surgery for advanced gastric cancer in elderly patients. Methods Clinical data about elderly gastric cancer patients （ ≥ 60 years） admitted to our hospital from January 2013 to December 2015 were retrospectively analyzed. Sixty-four patients who underwent SOX regimen combined with Dl＋ surgery and 64 patients who underwent D2 surgery were randomly selected in a case-control study. Results The baseline data was well matched in both two groups. The disease control rate and overall response rate of SOX neoadjuvant chemotherapy were 98.44% and 70.31% respectively. Occurrence rates of both grade 3 hematological and non-hematological toxicities were 6.25%, respectively. Compared to D2 surgery, SOX neoadjuvant chemotherapy combined with DI＋ surgery had the advantage of shorter operative time （206.72 ± 50.29 min vs 225.81 ± 50.75 min, t=1.913, P=0.034）, shorter postoperative ICU stay （21.23 ± 3.56 h vs 33.97± 4.43 h, t=3.355, P=-0.044）, less operative blood loss （241.41 ±48.99 ml vs 290.63 ± 41.95 ml, t=2.138, P=0.048）, and less surgical related complications （9.38% vs 21.88%, X 2=3.793, P=0.048）. In addition, the median overall survival was not significantly different between SOX neoadjuvant chemotherapy combined with D1＋ surgery group and D2 surgery group in elderly patients with advanced gastric cancer. Conclusion SOX regimen as neoadjuvant chemotherapy combined with DI＋ surgery is associated with high efficacy and safety in elderly advanced gastric cancer patients.
作者
吴晓松
梁文全
崔建新
郗洪庆
陈凛
WU Xiaosong LIANG Wenquan CUI Jianxin XI Hongqing CHEN Lin(Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China)
出处
《解放军医学院学报》
CAS
2017年第8期719-723,共5页
Academic Journal of Chinese PLA Medical School
基金
部委级资助项目
军队保健专项科研课题项目(15BJZ40)~~
关键词
进展期胃癌
老年人
新辅助化疗
胃癌根治术
advanced gastric cancer
aged
neoadjuvant chemotherapy
gastrectomy
