摘要
目的:探讨mDCF方案(多西他赛+奥沙利铂+亚叶酸钙+替加氟)新辅助化疗对进展期胃癌患者预后的影响。方法:选取2013-01~2016-01我院普外科收治的63例Ⅲ期进展期胃癌患者为研究对象,其中28例接受mDCF新辅助化疗(观察组),35例直接行手术治疗(对照组)。评估观察组的化疗疗效、不良反应发生情况,比较两组的近期生存情况。结果:观察组部分缓解12例,疾病稳定14例,疾病进展2例,临床获益率达92.9%,总缓解率达42.9%,且化疗后毒副反应主要以Ⅰ、Ⅱ级骨髓抑制为主,停药或给予对症治疗后均能恢复正常;两组的R0切除率比较,差异无统计学意义(P>0.05);观察组1年复发率为10.7%(3/28),3年复发率为32.1%(9/28),均低于对照组的31.4%(11/35)和60.0%(21/35),差异均有统计学意义(P<0.05)。观察组1年生存率为92.8%(26/28),3年生存率为67.8%(19/28),均高于对照组的88.6%(31/35)和42.9%(15/35),比较两组的3年生存率,差异均有统计学意义(P<0.05)。结论:mDCF方案新辅助化疗对进展期胃癌近期有一定疗效,能够降低患者复发率,提高患者生存时间,且不会产生严重毒副反应,但远期疗效还需进一步观察。
Objective: To investigate the effect of neoadjuvant chemotherapy with mDCF regimen (docetaxel+oxaliplatin+leucovorin+tegafur) on the prognosis of patients with advanced gastric cancer. Methods: Sixty-three patients with stage Ⅲ advanced gastric cancer from January 2013 to January 2016 in our hospital were selected.Twenty-eight patients were treated with mDCF neoadjuvant chemotherapy (observation group),thirty-five patients were treated with surgery (control group).Chemotherapy efficacy,adverse reactions occurred of observation group were evaluated,and the recent survival between the two groups were compared . Results: In the observation group,12 patients were partial response,14 patients were stable,2 patients were disease progression,the clinical benefit rate was 92.9%,and the total remission rate was 42.9%.The main side effects of chemotherapy were bone marrow suppression .Mainly,Ⅰ and Ⅱ were the main ones,and symptomatic treatment after drug withdrawal was normal.The R0 resection rate between the two groups has no significantly difference ( P >0.05).The recurrence rate at 1 year and 3 years of observation group were lower than those of control group (10.7% vs 31.4%,32.1% vs 60.0%)( P <0.05).The survival rate at 1 year and 3 years of observation group were higher than those of control group( P <0.05). Conclusion : mDCF regimen neoadjuvant chemotherapy has a certain effect on advanced gastric cancer in the near future,and will not produce serious toxic and side effects,which can reduce recurrence rate of patients and improve the survival rate of patients,but the long-term efficacy needs further observation.
作者
张勇
胡欢
王世垚
王亚运
郑鹏飞
程志斌
ZHANG Yong;HU Huan;WANG Shiyao;WANG Yayun;ZHENG Pengfei;CHENG Zhibin(The First Departerment of General Surgery,Second Hospital of Lanzhou University,Lanzhou 730030,China)
出处
《西北国防医学杂志》
CAS
2019年第8期480-485,共6页
Medical Journal of National Defending Forces in Northwest China
基金
甘肃省卫生行业科研计划资助项目(GSWST2013-03)
关键词
新辅助化疗
进展期胃癌
预后
neoadjuvant chemotherapy
advanced gastric cancer
prognosis
