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进展期胃癌新辅助化疗的临床疗效观察
作者:黄帅  郑朝旭  徐泉  袁兴华 
单位:北京协和医学院  中国医学科学院肿瘤医院腹部外科  北京 100021 
关键词:胃肿瘤/药物疗法 化学疗法 辅助 胃肿瘤/外科学 抗肿瘤联合化疗方案 预后 回顾性研究  
DOI:R735.2
出版年,卷(期):页码:2012,27(6):646-649
摘要:
目的 评价进展期胃癌新辅助化疗的疗效及对预后的影响。方法 回顾性分析45例确诊进展期胃癌患者通过新辅助化疗后再行手术治疗的疗效及预后,并与60例同期收治的未经新辅助化疗的胃癌手术患者进行对照。结果 新辅助化疗组临床有效率RR(CR+PR)为68.9%(31/45),其中CR 6.7%(3例),PR 62.2%(28例),SD 28.9%(13例),PD 2.2%(1例),术后1例在病理水平达到完全缓解(pCR),缓解率为2.2%(1/45)。不良反应主要为Ⅰ及Ⅱ度白细胞减少、恶心、脱发、呕吐及黏膜炎,其中Ⅲ及Ⅳ级的白细胞减少及胃肠道反应6例(13.3%),无严重感染和死亡病例。新辅助化疗组手术根治性切除率为84.4%,对照组的手术根治性切除率为66.7%,两者差异有统计学意义(P < 0.05)。与对照组比较,新辅助化疗组的术后生存期明显延长(P < 0.05),且两组术后并发症无明显差异。结论 手术切除较为困难或根治率低的局部晚期胃癌患者,术前配合新辅助化疗,可显着提高胃癌切除率,并且最终可明显提高胃癌患者的术后生存期。
Objective To evaluate the efficacy of neoadjuvant chemotherapy in the treatment of advanced gastric cancer. Methods Forty five patients with advanced gastric cancer were treated with neoadjuvant chemotherapy followed by surgical resection, the therapeutic effects and survival of patients were retrospectively analyzed. Sixty matched patients with gastric cancer were served as control group. Results The outcomes of neoadjuvant chemotherapy were 3 CR(6.7%, including 1 case of pathological CR), 28 PR (62.2%), 13 SD(28.9%), 1 PD(2.2%) with an overall response rate of 68.9%. The side-effects of neoadjuvant chemotherapy mainly were mild, no case of severe infection and death was observed. The rate of surgical radical resection in neoadjuvant group was 84.4%, while that in control group was 66.7%; and the survival was significantly prolonged in neoadjuvant group (P < 0.05). Conclusion Neoadjuvant chemotherapy is beneficial for patients with late-stage gastric cancer, which may increase the surgical resection rate and improve postoperative survival.
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