局部进展期胃癌D2根治术后同步放化疗与单纯化疗的疗效比较

发布时间：2018-01-02 15:46

本文关键词：局部进展期胃癌D2根治术后同步放化疗与单纯化疗的疗效比较　出处：《第二军医大学学报》2016年02期 　论文类型：期刊论文

【摘要】：目的比较局部进展期胃癌D2根治术后同步放化疗与单纯化疗的疗效和不良反应。方法选取接受根治术的局部进展期胃癌患者79例(R0切除,D2淋巴结清扫),随机分为2组。试验组40例,采用放疗同步卡培他滨化疗序贯4周期奥沙利铂联合卡培他滨(XELOX)方案化疗。对照组39例,术后仅予以6周期奥沙利铂联合卡培他滨(XELOX)方案化疗。比较两组患者局部复发率、3年无病生存率、3年总生存率及不良反应。结果与对照组比较,试验组局部复发率降低[64.1%(25/39)vs 40.0%(16/40),P=0.032],3年无病生存率和3年总生存率比较有所增高,但差异无统计学意义(P0.05);试验组和对照组淋巴结阳性患者3年生存率分别为45.2%(14/31)和18.5%(5/27)(P=0.049),中位无病生存期分别为26个月和19个月(P=0.024)。试验组血液毒性和胃肠道反应发生率较高。结论局部进展期胃癌根治术后同步放化疗序贯化疗较单纯化疗可以降低局部复发率,对于淋巴结阳性患者有改善生存的趋势。主要不良反应为血液毒性及胃肠道反应。
[Abstract]:The efficacy and adverse reactions of radical resection of locally advanced gastric cancer objective to compare D2 after chemoradiotherapy and chemotherapy. Methods 79 cases underwent gastrectomy for locally advanced gastric cancer patients (R0 resection, lymph node dissection, D2) were randomly divided into 2 groups. 40 cases in experimental group, the radiotherapy combined with capecitabine chemotherapy 4 sequential cycles of capecitabine combined with oxaliplatin (XELOX) chemotherapy. 39 cases in the control group, after only 6 cycles of oxaliplatin combined with capecitabine (XELOX) chemotherapy. Compared two groups of patients with local recurrence, disease-free survival at 3 years, 3 years survival rate and the results and adverse reactions. Compared to the control group, the test group decreased local recurrence of [64.1% (25/39) vs 40% (16/40), P=0.032], the 3 year disease free survival rate and 3 year survival rate is increased, but the difference was not statistically significant (P0.05); the experimental group and the control group of patients with lymph node positive 3 year survival rates were 45. 2% (14/31) and 18.5% (5/27) (P=0.049), median disease-free survival was 26 months and 19 months (P=0.024). The test group of hematological toxicity and gastrointestinal reaction rate is higher. Conclusion radical resection of locally advanced gastric cancer after radiotherapy and chemotherapy sequential chemotherapy than chemotherapy can reduce local the recurrence rate for patients with positive lymph nodes have improved survival trend. The main adverse reactions were hematologic toxicity and gastrointestinal reactions.

【作者单位】：安徽医科大学第一附属医院肿瘤内科;安庆市第一人民医院肿瘤内科;安徽省立医院肿瘤放疗科;
【分类号】：R735.2
【正文快照】： [Acad J Sec Mil Med Univ,2016,37(2):177-183]手术是胃癌的主要治疗方式。临床研究证实,在局部进展期胃癌接受D2根治术后辅助化疗,能改善生存[1-2]。放疗最初仅限于胃癌的姑息对症治疗,随着三维放疗的开展,越来越多的研究者将放疗应用于胃癌术后的辅助治疗中。其中SWOG/INT0

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