挽救性放疗在局部晚期胃癌根治术后区域淋巴结复发中的作用

发布时间：2018-03-08 21:17

本文选题：胃癌　切入点：淋巴结　出处：《世界最新医学信息文摘》2017年70期 　论文类型：期刊论文

【摘要】：目的分析研讨挽救性放疗在局部晚期胃癌根治术后区域淋巴结复发中的作用。方法本次讨论中所研讨的78例患者均随机从我院2015年11月至2016年10月收治的胃癌根治术后区域淋巴结复发患者中筛选而出,排除有远处转移及腹膜种植转移的患者,对其进行挽救性放疗,将其治疗结果纳入对比研讨中。结果挽救性治疗状况:24例患者仅化疗,36例患者进行化疗后放疗或进行同步化疗,另外18例患者首选放疗(不加或加化疗)。经过挽救性治疗后,21例患者完全得到缓解,其中9例患者在最后随访期间无病生存,有12例患者远处转移;另外57例患者中,51例患者肿瘤进展。放疗组局部复发15例,复发率为27.78%(15/54),化疗组局部复发21例,复发率为87.50%(21/24)。两组复发率对比有统计学意义(P0.05);患者无病生存期和总生存期:放疗组中位PFS为20个月,化疗组为6个月,两组对比有统计学意义(P0.05);此外,先接受化疗后行放疗的OS(中位OS为36个月)比单独行化疗(中位OS为15个月)优,组间数据有统计学意义(P0.05);急性毒性反应:放疗期间,36例患者出现急性胃肠道毒性,毒副反应为腹部不适和恶心,经对症治疗后,患者症状得到缓解,无病例出现3级以上或者其他毒副反应;挽救性化疗期间,22例患者出现骨髓抑制,4例患者出现口腔炎。经对症治疗后,有所好转。结论挽救性放疗可作为局部晚期胃癌根治术后区域淋巴结复发的有效治疗方式,可延长患者生存时间,值得临床应用。
[Abstract]:Objective to analyze the role of salvage radiotherapy in regional lymph node recurrence after radical resection of local advanced gastric cancer. Methods 78 cases of gastric cancer treated in our hospital from November 2015 to October 2016 were randomly selected from November 2015 to October 2016. The patients with regional lymph node recurrence after operation were screened out. Patients with distant metastases and peritoneal implants were excluded and treated with salvage radiotherapy. Results Rescue therapy was carried out in 36 patients with chemotherapy only after chemotherapy or with concurrent chemotherapy. The other 18 patients were treated with radiotherapy (without or with chemotherapy). After salvage therapy, 21 patients were completely relieved, 9 patients survived without disease during the last follow-up period, 12 patients had distant metastasis. In the other 57 cases, 51 cases were tumor progression, 15 cases were local recurrence in radiotherapy group, the recurrence rate was 27.78% and 21 cases in chemotherapy group. The recurrence rate of the two groups was 87.50% / 24%. There was significant difference in the recurrence rate between the two groups (P 0.05). The median PFS of the radiotherapy group was 20 months and the chemotherapy group was 6 months. In addition, there was significant difference between the two groups. The OS (median OS = 36 months) received chemotherapy and radiotherapy (median OS = 15 months) was superior to chemotherapy alone (median OS = 15 months), and the data between groups were statistically significant (P 0.05). Acute toxicity: acute gastrointestinal toxicity was found in 36 patients during radiotherapy. The side effects were abdominal discomfort and nausea. After symptomatic treatment, the symptoms of the patients were alleviated, and no cases appeared grade 3 or other side effects. During salvage chemotherapy, 22 patients with bone marrow suppression and 4 patients with stomatitis were found. Conclusion Rescue radiotherapy can be used as an effective treatment for regional lymph node recurrence after radical resection of local advanced gastric cancer. It can prolong the survival time of patients and is worthy of clinical application.
【作者单位】：山东省蒙阴县人民医院;
【分类号】：R735.2

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