摘要
目的:探讨适形放疗和XELOX方案(奥沙利铂+卡培他滨)联合治疗腹腔淋巴结转移胃癌患者的临床疗效和机制.方法:将40例胃癌根治术后出现腹腔淋巴结转移患者随机分为对照组19例和治疗组21例,治疗组给予适形放疗联合XELOX方案(奥沙利铂+卡培他滨),对照组仅给予XELOX方案进行化疗.统计并比较两组患者的临床疗效、术后生存率和不良反应发生情况,采用ELISA法对患者术前、术后外周血白介素-2(interleukin-2,IL-2)和IL-6的水平进行测定.结果:治疗组总有效率为82%;明显优于对照组的52.7%,差异有统计学意义(2=3.65,P<0.05);治疗组与对照组2、3年的术后生存率分别为61.9%vs 42.1%、52.3%vs 21.1%,差异均有统计学意义(P<0.05);治疗组骨髓抑制、胃肠道反应、贫血和肝功能损伤等不良反应的发生率高于对照组,但差异无统计学意义(P>0.05);两组患者术后IL-6水平下降,IL-2升高,其中术后6 mo时两组患者的IL-2和IL-6水平与术前比较差异有统计学意义(P<0.05).结论:胃癌根治术后腹腔淋巴结转移患者采用适形放疗联合XELOX方案治疗可明显提高疗效和患者的术后生存率,延长生存期,不良反应可耐受,但不良反应发生情况高于单独化疗的患者,但因本研究病例数较少,有待于进一步研究.
AIM： To investigate the effect of conformal radiation therapy combined with XELOX （capecitabine plus oxaliplatin） chemotherapy in the treatment of abdominal lymph node metas- tasis in patients with gastric cancer after surgery. METHODS： Forty patients who developed ab- dominal lymph node metastasis after surgery for gastric cancer were randomly divided into either a control group （n = 19） or a treatment group （n -- 21）. The treatment group was given conformal radiation therapy combined with chemotherapy with XELOX （xeloda ＋ oxaliplatin）, and the con- trol group received XELOX chemotherapy only. Clinical efficacy, postoperative survival rate and adverse reactions were compared between the two groups. The levels of interleukin-2 （IL-2） and interleukin-6 （IL-6） in peripheral blood of all subjects were measured by ELISA preopera- tively and postoperatively. RESULTS： Total response rate was significantly higher in the treatment group than in the control group （82.0% vs 52.7%, 2 = 3.65, P 〈 0.05）. The 1- and 2-year postoperative survival rates were also significantly higher in the treatment group than in the control group （61.9% vs 42.1%, 52.3% vs 21.1%, both P 〈 0.05）. The incidence of ad- verse reactions （bone marrow suppression, gas- trointestinal reactions, anemia, and liver func- tion damage） showed no significant difference between the two groups （P 〉 0.05）. Six months after the treatment, peripheral blood levels of IL-6 were decreased and those of IL-2 were in- creased in two groups, and the difference was significant （both P 〈 0.05）. CONCLUSION： Conformal radiation therapy combined with XELOX chemotherapy can sig- nificantly improve curative effect and postop- erative survival in gastric cancer patients with postoperative abdominal lymph node metasta- sis, and is associated with tolerable side effects.
出处
《世界华人消化杂志》
CAS
北大核心
2013年第31期3413-3417,共5页
World Chinese Journal of Digestology
