Ⅱ、Ⅲ期胃癌FOLFOX4方案新辅助化疗研究
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摘要
目的探讨Ⅱ、Ⅲ期胃癌患者术前新辅助化疗的临床效果。方法收集2015年1月至2017年6月经我院病理确诊为胃癌,且增强CT术前分期确定为Ⅱ、Ⅲ期的患者47例,随机分为观察组和对照组,观察组予术前新辅助化疗+手术治疗+术后化疗,对照组予手术治疗+术后化疗。比较两组的肿瘤R0切除率、复发率、 1年生存率及化疗不良反应。结果观察组术前新辅助化疗后的胃癌临床分期相比化疗前下降,差异有统计学意义(P <0.05);观察组的肿瘤R0切除率及1年生存率显著高于对照组,术后复发率显著低于对照组,差异有统计学意义(P <0.05);两组对化疗药的不良反应均较轻,组间差异无统计学意义(P>0.05)。结论手术联合FOLFOX4方案新辅助化疗可提高胃癌患者的治疗效果,且不增加化疗毒副作用,值得临床应用。
Objective To explore the clinic effect of preoperative neoadjuvant chemotherapy in patients with gastric cancer in stageⅡ and Ⅲ. Methods 47 patients pathologically diagnosed as gastric cancer and classified into stage Ⅱ and Ⅲ by enhanced CT scanning in our hospital from January 2015 to June 2017 were collected and randomly divided into observation group and control group. Patients in the observation group were given preoperative neoadjuvant chemotherapy + surgery + postoperative chemotherapy, while patients in the control group were given surgery + postoperative chemotherapy. The tumor R0 resection rate, recurrence rate, 1-year survival rate and side effect of chemotherapy were compared between the two groups. Results After preoperative neoadjuvant chemotherapy, the clinic stage of patients in the observation group declined compared with that before chemotherapy, with statistically significant difference(P <0.05). Compared with the control group, the observation group had higher tumor R0 resection and postoperative 1-year survival rate, but lower recurrence rate, with statistically significant differences(P <0.05). Both groups had slight side effects of chemotherapy, and no significant difference was found in side effects of chemotherapy between the two groups(P >0.05). Conclusions Surgery combined with neoadjuvant chemotherapy with FOLFOX4 regimen can improve the curative effect of patients with gastric cancer, without the increase of side effects of chemotherapy,which is worthy of clinical application.
Objective To explore the clinic effect of preoperative neoadjuvant chemotherapy in patients with gastric cancer in stageⅡ and Ⅲ. Methods 47 patients pathologically diagnosed as gastric cancer and classified into stage Ⅱ and Ⅲ by enhanced CT scanning in our hospital from January 2015 to June 2017 were collected and randomly divided into observation group and control group. Patients in the observation group were given preoperative neoadjuvant chemotherapy + surgery + postoperative chemotherapy, while patients in the control group were given surgery + postoperative chemotherapy. The tumor R0 resection rate, recurrence rate, 1-year survival rate and side effect of chemotherapy were compared between the two groups. Results After preoperative neoadjuvant chemotherapy, the clinic stage of patients in the observation group declined compared with that before chemotherapy, with statistically significant difference(P <0.05). Compared with the control group, the observation group had higher tumor R0 resection and postoperative 1-year survival rate, but lower recurrence rate, with statistically significant differences(P <0.05). Both groups had slight side effects of chemotherapy, and no significant difference was found in side effects of chemotherapy between the two groups(P >0.05). Conclusions Surgery combined with neoadjuvant chemotherapy with FOLFOX4 regimen can improve the curative effect of patients with gastric cancer, without the increase of side effects of chemotherapy,which is worthy of clinical application.
引文
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[8]刘海忠,王天飞,韩东海,等.替吉奥联合奥沙利铂在进展期胃癌新辅助化疗中的效果[J].现代实用医学, 2012, 24(2):178-180.
[2]耿春玲,秦美林,张桦.新辅助化疗治疗进展期胃癌的疗效与优越性分析[J].世界复合医学, 2016, 2(3):34-36.
[3] Eskens FA, van Erpecum KJ, de Jong KP, et al. Hepatocellular carci-noma:Dutch guideline for surveillance, diagnosis and therapy[J].Neth J Med, 2014, 72(6):299-304.
[4] Kweekel DM, Antonini NF, Nortier JW, et al. Explorative study to iden-tify novel candidate genes related to oxaliplatin efficacy and toxicityusing a DNA repair array[J]. Br J Cancer, 2009, 101(2):357-362.
[5] Foukakis T, Lundell L, Gubanski M, et al. Advances in the treatmentof patients with gastric adenocarcinoma[J]. Acta Oncol, 2007, 46(3):277-285.
[6] Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemother-apy versus surgery alone for resectable gastroesophageal cancer[J]. NEngl J Med, 2006, 355(1):11-20.
[7] Okines AF, Norman AR, McCloud P, et al. Meta-analysis of the RE-AL-2 and ML17032 trials:evaluating capecitabine-based combinationchemotherapy and infused 5-fluorouracil-based combination chemother-apy for the treatment of advanced oesophago-gastric cancer[J]. AnnOncol, 2009, 20(9):1529-1534.
[8]刘海忠,王天飞,韩东海,等.替吉奥联合奥沙利铂在进展期胃癌新辅助化疗中的效果[J].现代实用医学, 2012, 24(2):178-180.