摘要
目的：探讨可切除局部晚期食管胃结合部腺癌行新辅助化疗（奥沙利铂＋卡培他滨， XELOX方案）的临床疗效。方法： 采用前瞻性研究方法。选取2011年1月至2014年12月汕头大学医学院附属肿瘤医院收治的106例可切除局部晚期食管胃结合部腺癌患者的临床病理资料。采用随机、单盲对照研究，通过随机数字表法将入组患者分为试验组和对照组；试验组采用新辅助化疗（XELOX方案）＋手术治疗＋术后辅助化疗（XELOX方案），对照组采用手术治疗＋术后辅助化疗（XELOX方案）。两组患者由同一组手术医师行全胃切除＋食管空肠Roux-en-Y吻合＋D2淋巴结清扫术。观察指标：（1）治疗情况。（2）术后病理学检查结果。（3）随访和生存情况。采用门诊方式进行随访，了解患者肿瘤复发、转移和生存情况，随访时间截至2017年2月。正态分布的计量资料以±s表示，组间比较采用t检验。非正态分布的计量资料以M（范围）表示，采用非参数检验。计数资料比较采用x2检验。等级资料比较采用非参数检验。采用KaplanMeier法绘制生存曲线和计算生存率，采用Logrank检验比较生存情况。结果：筛选出符合研究条件的患者106例，其中试验组54例，对照组52例。（1）治疗情况：①术前新辅助化疗情况：54例试验组患者术前行新辅助化疗2-4个周期，化疗期间胃肠道反应21例，1-2级粒细胞减少症17例，谷丙转氨酶（ALT）升高8例，3级粒细胞减少症1例，无不良反应7例。54例试验组患者术前新辅助化疗疗效：完全缓解4例，部分缓解27例，疾病稳定20例，疾病进展3例。54例试验组患者术前新辅助化疗反应程度：0级4例，1级13例，2级25例，3级12例。②手术治疗情况：试验组与对照组患者术前癌胚抗原分别为4.71 μg/L （0.20-36.19 μg/L）、14.09 μg/L （0.71-178.20 μg/L） ，两组比较，差异有统
Objective： To investigate the clinical efficacy of neoadjuvant chemotherapy （oxaliplatin ＋ capecitabine, XELOX） for the resectable locally advanced adenocarcinoma of esophagealgastric junction （AEG）. Methods：The prospective study was conducted. The clinicopathological data of 106 locally advanced AEG patients who were admitted to the Cancer Hospital of Shantou University Medical College from January 2011 to December 2014 were collected. All the patients were divided into the treatment group and control group by single blind, randomized, controlled random number table. Patients underwent preoperative neoadjuvant chemotherapy （XELOX） ＋ surgery ＋ postoperative adjuvant chemotherapy （XELOX） in the treatment group and surgery ＋ postoperative adjuvant chemotherapy （XELOX） in the control group. Total gastrectomy ＋ Roux-en-Y esophagojejunostomy ＋ D2 lymphadenectomy were applied to patients by the same team of doctors. Observation indicators： （1） treatment situations; （2） results of postoperative pathological examination; （3） followup and survival situations. Followup using outpatient examination was performed to detect the postoperative tumor recurrence or metastasis and patients′ survival up to February 2017. Measurement data with normal distribution were represented as ±s, and comparisons between groups were evaluated with the t test. Measurement data with skewed distribution were described as M （range） and analyzed by the nonparametric test. Comparisons of count data were analyzed using the chisquare test. The ordinal data were compared using the nonparametric test. Survival rate and curve were respectively calculated and drawn by the KaplanMeier method and survivals were compared using the Longrank method.
Results：One hundred and six patients were screened for eligibility, including 54 in the treatment group and 52 in the control group. （1） Treatment situations： ① preoperative neoadjuvant chemotherapy： 54 in the treatment group received 2-4 cycle
作者
林佳锐
庄业忠
王伟峰
李镠洋
翁桢泓
黄棉生
许慕明
Lin Jiarui;Zhuang Yezhong;Wang Weifeag;Li Liuyang;Weng Zhenhong;Huang Miansheng;Xu Muming.(Department of Abdominal Surgery, Cancer Hospital of Shantou University Medical College, Shantou 515000, Guangdong Province, China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2018年第6期619-625,共7页
Chinese Journal of Digestive Surgery
基金
广东省中医药局科研项目（20171177）
关键词
食管胃结合部肿瘤
局部晚期
新辅助化疗
Adenocarcinoma of esophagogastric junction
Locally advanced
Neoadjuvant chemotherapy
