术后三维适形放疗联合卡培他滨化疗治疗进展期胃癌的临床效果
|
摘要
目的探讨术后三维适形放疗联合卡培他滨化疗治疗进展期胃癌的临床效果。方法回顾性分析青海省第五人民医院2012年1月～2017年12月收治的150例进展期胃癌患者临床资料,依据治疗方式不同分为两组,化疗组(卡培他滨化疗)50例和放疗联合化疗组(三维适形放疗联合卡培他滨化疗)100例,两组患者均连续治疗2个周期。观察两组进展期胃癌患者治疗前后生存质量情况,观察两组患者临床疗效和不良反应发生率。结果两组患者治疗前生存质量评分比较,差异无统计学意义(P> 0.05),治疗后两组患者生存质量评分均高于治疗前,且放疗联合化疗组患者生存质量评分高于化疗组,放疗联合化疗组患者缓解率高于化疗组,放疗联合化疗组患者白细胞减少、血红蛋白减少、恶心呕吐发生率均高于化疗组,差异均有统计学意义(P <0.05),两组患者血小板减少、肢端麻木发生率比较,差异无统计学意义(P> 0.05)。结论进展期胃癌术后三维适形放疗联合卡培他滨化疗,可以提高患者生存质量和临床治疗缓解率,但是白细胞减少、血红蛋白减少、恶心呕吐发生率较高。
Objective To investigate the clinical effect of postoperative three-dimensional conformal radiotherapy combined with capecitabine chemotherapy in the treatment of advanced gastric cancer. Method The 150 cases' clinical data of progressive gastric cancer in the Fifth People's Hospital Qinghai province from January 2012 to December 2017 were analyzed retrospectively, and they were divided into two groups, 50 patients in the chemotherapy group(capecitabine chemotherapy) and 100 cases in the radiotherapy combined chemotherapy group(three-dimensional conformal radiotherapy combined Kapetabine chemotherapy) were treated for 2 consecutive cycles. The quality of life of patients in the two groups before and after treatment was observed, and the clinical efficacy and incidence of adverse reactions were observed. Results The life quality scores of patients in the two groups before treatment had no significant differences(P > 0.05). Quality of life scores in the two groups after treatment were higher than before the treatment, chemotherapy and radiotherapy patients quality of life score in the radiotherapy combined chemotherapy group was higher than chemotherapy group, remission rate of patients in the radiotherapy combined chemotherapy group was higher than chemotherapy group, leukopenia, hemoglobin reduces, the incidence of nausea and vomiting of patients in chemotherapy group were higher than chemotherapy group, the difference had statistical significance(P < 0.05),There was no significant difference in the incidence of thrombocytopenia and extremity numbness between the two groups(P > 0.05). Conclusion The progressive gastric cancer after operation by three-dimensional conformal radiotherapy combined with kapetabine chemotherapy, which could increase life quality and the clinical treatment remission rate, but the incidence of leucopenia, reducing hemoglobin, and nausea vomiting rate are high.
Objective To investigate the clinical effect of postoperative three-dimensional conformal radiotherapy combined with capecitabine chemotherapy in the treatment of advanced gastric cancer. Method The 150 cases' clinical data of progressive gastric cancer in the Fifth People's Hospital Qinghai province from January 2012 to December 2017 were analyzed retrospectively, and they were divided into two groups, 50 patients in the chemotherapy group(capecitabine chemotherapy) and 100 cases in the radiotherapy combined chemotherapy group(three-dimensional conformal radiotherapy combined Kapetabine chemotherapy) were treated for 2 consecutive cycles. The quality of life of patients in the two groups before and after treatment was observed, and the clinical efficacy and incidence of adverse reactions were observed. Results The life quality scores of patients in the two groups before treatment had no significant differences(P > 0.05). Quality of life scores in the two groups after treatment were higher than before the treatment, chemotherapy and radiotherapy patients quality of life score in the radiotherapy combined chemotherapy group was higher than chemotherapy group, remission rate of patients in the radiotherapy combined chemotherapy group was higher than chemotherapy group, leukopenia, hemoglobin reduces, the incidence of nausea and vomiting of patients in chemotherapy group were higher than chemotherapy group, the difference had statistical significance(P < 0.05),There was no significant difference in the incidence of thrombocytopenia and extremity numbness between the two groups(P > 0.05). Conclusion The progressive gastric cancer after operation by three-dimensional conformal radiotherapy combined with kapetabine chemotherapy, which could increase life quality and the clinical treatment remission rate, but the incidence of leucopenia, reducing hemoglobin, and nausea vomiting rate are high.
引文
[1]曹焱,潘慧丽,郑光浩,等.三维适形放疗联合替吉奥胶囊口服化疗治疗局部晚期胃癌疗效观察[J].现代生物医学进展,2017,17(16):3107-3110,3132.
[2]Wang T,Zhang SF,Qiu MQ,et al.Efficacy and safety of S-1(tegafur,gimeracil,and oteracil potassium)concurrent with 3-dimensional conformal radiotherapy for newly diagnosed squamous cell carcinoma of the lung in elderly patients[J].Cancer Radiother,2016,20(3):181-186.
[3]陈兰兰,高立明,程少会,等.三维适形放疗同步替吉奥胶囊治疗局部晚期胃癌疗效观察[J].中国疗养医学,2018,27(1):57-59.
[4]Lu W,Gao J,Yang J,et al.Long-term clinical outcomes of laparoscopy-assisted distal gastrectomy versus open distal gastrectomy for early gastric cancer:A comprehensive systematic review and meta-analysis of randomized control trials[J].Medicine,2016,95(27):e3986.
[5]刘广国,肖仕明,赵清梅,等.局部进展期胃癌根治术后三维适形放疗联合同期化疗与单纯化疗的对比研究[J].现代中西医结合杂志,2015,24(30):3321-3323,3327.
[6]Gerardina S,Edy I,Sonia S,et al.A new three-dimensional conformal radiotherapy(3DCRT)technique for large breast and/or high body mass index patients:evaluation of a novel fields assessment aimed to reduce extra-target-tissue irradiation[J].Br J Radiol,2016,89(1065):20160039.
[7]张月芬,王文然,杨玉刚,等.多野照射、三维适形放疗与调强放疗对胃癌根治术患者癌周围组织的影响[J].现代生物医学进展,2017,17(7):1277-1280.
[8]Leite ET,Ugino RT,Santana MA,et al.Incidental irradiation of internal mammary lymph nodes in breast cancer:conventional two-dimensional radiotherapy versus conformal three-dimensional radiotherapy[J].Radiol Bras,2016,49(3):170-175.
[9]刘丽霞,李国平,孙刚庆.胃癌术后三维适形放疗同步XELOX方案治疗的临床疗效[J].江苏医药,2014,40(13):1536-1538.
[10]Haciislamoglu E,Colak F,Canyilmaz E,et al.The choice of multi-beam IMRT for whole breast radiotherapy in early-stage right breast cancer[J].Springerplus,2016,5(1):688.
[11]蒋鹏飞.进展期胃癌术后三维适形放疗联合卡培他滨化疗的疗效[J].医学理论与实践,2017,30(15):2244-2246.
[12]Tesfaye A,Marshall JL,Smaglo BG.Approach to the medical management of surgically resectable gastric cancer[J].J Clin Oncol,2016,14(2):129-135.
[13]李广连,国滨,李金芳,等.进展期胃癌术后替吉奥联合奥沙利铂化疗后序贯三维适形放疗的疗效及安全性观察[J].中华临床医师杂志:电子版,2014,8(22):3962-3965.
[14]Yao Y,Xu M,Liang L,et al.Genome-wide analysis of Epstein-Barr virus identifies variants and genes associated with gastric carcinoma and population structure[J].Tumour Biol,2017,39(10):1-10.
[15]胡云峰,赵红,崔洁,等.三维适形放疗同步卡培他滨化疗治疗老年胃癌[J].现代肿瘤医学,2016,24(2):273-276.
[16]Stumpf PK,Amini A,Jones BL,et al.Adjuvant radiotherapy improves overall survival in patients with resected gastricade nocarcinoma:A National Cancer Data Base analysis[J].Cancer,2017,123(17):3402-3409.
[17]张大海,蔡忠芳,马海锋.替吉奥胶囊联合三维适形放疗在胃癌进展期的应用效果[J].中华全科医学,2014,12(9):1411-1412,1522.
[18]Yokohata T,Takeshima T,Iida T,et al.Significance of Endoscopic Examination in Diagnosis of Upper Gastrointestinal Perforation[J].Digestion,2016,93(1):109-112.
[19]韩刚,王以东,曹羽,等.进展期胃癌术后三维适形放疗联合XELOX方案化疗的疗效观察[J].实用癌症杂志,2013,28(2):168-170.
[20]Cho SJ,Kook MC,Lee JH,et al.Peroxisome proliferatoractivated receptor gamma upregulates galectin-9 and predicts prognosis in intestinal-type gastric cancer[J].Int J Cancer,2015,136(4):810-820.
[2]Wang T,Zhang SF,Qiu MQ,et al.Efficacy and safety of S-1(tegafur,gimeracil,and oteracil potassium)concurrent with 3-dimensional conformal radiotherapy for newly diagnosed squamous cell carcinoma of the lung in elderly patients[J].Cancer Radiother,2016,20(3):181-186.
[3]陈兰兰,高立明,程少会,等.三维适形放疗同步替吉奥胶囊治疗局部晚期胃癌疗效观察[J].中国疗养医学,2018,27(1):57-59.
[4]Lu W,Gao J,Yang J,et al.Long-term clinical outcomes of laparoscopy-assisted distal gastrectomy versus open distal gastrectomy for early gastric cancer:A comprehensive systematic review and meta-analysis of randomized control trials[J].Medicine,2016,95(27):e3986.
[5]刘广国,肖仕明,赵清梅,等.局部进展期胃癌根治术后三维适形放疗联合同期化疗与单纯化疗的对比研究[J].现代中西医结合杂志,2015,24(30):3321-3323,3327.
[6]Gerardina S,Edy I,Sonia S,et al.A new three-dimensional conformal radiotherapy(3DCRT)technique for large breast and/or high body mass index patients:evaluation of a novel fields assessment aimed to reduce extra-target-tissue irradiation[J].Br J Radiol,2016,89(1065):20160039.
[7]张月芬,王文然,杨玉刚,等.多野照射、三维适形放疗与调强放疗对胃癌根治术患者癌周围组织的影响[J].现代生物医学进展,2017,17(7):1277-1280.
[8]Leite ET,Ugino RT,Santana MA,et al.Incidental irradiation of internal mammary lymph nodes in breast cancer:conventional two-dimensional radiotherapy versus conformal three-dimensional radiotherapy[J].Radiol Bras,2016,49(3):170-175.
[9]刘丽霞,李国平,孙刚庆.胃癌术后三维适形放疗同步XELOX方案治疗的临床疗效[J].江苏医药,2014,40(13):1536-1538.
[10]Haciislamoglu E,Colak F,Canyilmaz E,et al.The choice of multi-beam IMRT for whole breast radiotherapy in early-stage right breast cancer[J].Springerplus,2016,5(1):688.
[11]蒋鹏飞.进展期胃癌术后三维适形放疗联合卡培他滨化疗的疗效[J].医学理论与实践,2017,30(15):2244-2246.
[12]Tesfaye A,Marshall JL,Smaglo BG.Approach to the medical management of surgically resectable gastric cancer[J].J Clin Oncol,2016,14(2):129-135.
[13]李广连,国滨,李金芳,等.进展期胃癌术后替吉奥联合奥沙利铂化疗后序贯三维适形放疗的疗效及安全性观察[J].中华临床医师杂志:电子版,2014,8(22):3962-3965.
[14]Yao Y,Xu M,Liang L,et al.Genome-wide analysis of Epstein-Barr virus identifies variants and genes associated with gastric carcinoma and population structure[J].Tumour Biol,2017,39(10):1-10.
[15]胡云峰,赵红,崔洁,等.三维适形放疗同步卡培他滨化疗治疗老年胃癌[J].现代肿瘤医学,2016,24(2):273-276.
[16]Stumpf PK,Amini A,Jones BL,et al.Adjuvant radiotherapy improves overall survival in patients with resected gastricade nocarcinoma:A National Cancer Data Base analysis[J].Cancer,2017,123(17):3402-3409.
[17]张大海,蔡忠芳,马海锋.替吉奥胶囊联合三维适形放疗在胃癌进展期的应用效果[J].中华全科医学,2014,12(9):1411-1412,1522.
[18]Yokohata T,Takeshima T,Iida T,et al.Significance of Endoscopic Examination in Diagnosis of Upper Gastrointestinal Perforation[J].Digestion,2016,93(1):109-112.
[19]韩刚,王以东,曹羽,等.进展期胃癌术后三维适形放疗联合XELOX方案化疗的疗效观察[J].实用癌症杂志,2013,28(2):168-170.
[20]Cho SJ,Kook MC,Lee JH,et al.Peroxisome proliferatoractivated receptor gamma upregulates galectin-9 and predicts prognosis in intestinal-type gastric cancer[J].Int J Cancer,2015,136(4):810-820.