摘要
目的探讨多西他赛联合奥沙利铂+替吉奥/卡培他滨方案在进展期胃癌新辅助化疗中的疗效和不良反应。方法 143例行新辅助化疗的进展期胃癌患者,其中90例采用奥沙利铂+替吉奥/卡培他滨方案(对照组),53例采用多西他赛联合奥沙利铂+替吉奥/卡培他滨方案(观察组)。观察2组患者治疗效果和不良反应发生率;比较2组手术切除率、显微镜下无残留(R0)切除率、病理退缩率和无病生存期;应用Kaplan-Meier法分析不同治疗方案和肿瘤退缩程度与预后的关系。结果观察组临床有效率(52.8%)、手术切除率(56.6%)、R0切除率(54.7%)均高于对照组(31.1%、32.2%、28.9%)(P<0.05),术后显著肿瘤退缩比率(63.3%)、N0分期比率(53.3%)高于对照组(24.1%、24.1%)(P<0.05),疾病控制率(94.3%)、T分期降期比率(50.9%)和N分期降期比率(49.1%)与对照组(81.1%、46.7%、45.6%)比较差异均无统计学意义(P>0.05);观察组Ⅲ级以上白细胞计数减少(24.6%)、中性粒细胞计数减少(32.1%)、血小板计数减少(28.3%)发生率高于对照组(8.9%、11.1%、6.7%)(P<0.05);术后观察组患者中位无病生存期(29个月)与对照组(26个月)比较差异无统计学意义(P>0.05);术后病理分期显著肿瘤退缩患者中位无病生存期(30.5个月)高于不显著肿瘤退缩者(25个月)(P<0.05)。结论在奥沙利铂+替吉奥/卡培他滨基础上加用多西他赛治疗进展期胃癌患者可提高临床有效率、手术切除率、R0切除率、术后显著肿瘤退缩率,且肿瘤退缩显著的患者术后生存期长,但不良反应发生率较高。
Objective To investigate the effect and adverse reactions of docetaxel+oxaliplatin+S-1/capecitabine in neoadjuvant chemotherapy for advanced gastric cancer. Methods Totally 143 patients with advanced gastric cancer were divided into observation group(n=53) receiving docetaxel+oxaliplatin+S-1/capecitabine, and control group(n=90) receiving oxaliplatin+S-1/capecitabine. The curative effect of chemotherapy, related adverse reactions and tumor regression grade were observed in two groups. The resection rate, R0 resection rate, pathological regression rate and disease-free survival time were compared between two groups. The relationship of different regimens and the tumor regression grade with the prognosis was analyzed by Kaplan-Meier method. Results The clinical effective rate(52.8%), resection rate(56.6%), R0 resection rate(54.7%), percentage of postoperative significant tumor regression grade rate(63.3%) and percentage of N0 staging reduction rate(53.3%) in observation group were higher than those in control group(31.1%, 32.2%, 28.9%, 24.1%, 24.1%)(P<0.05), while there were no significant differences in disease control rate(94.3% vs 81.1%), T stage reduction rate(50.9% vs 50.9%) and N stage reduction rate(49.1% vs 45.6%) between observation group and control group(P>0.05). The incidences of leukopenia ≥ 3 grade, neutropenia and thrombocytopenia were higher in observation group(24.6%, 32.1%, 28.3%) than those in control group(8.9%, 11.1%, 6.7%)(P<0.05). There was no significant difference in the median disease-free survival time between observation group(29 months) and control group(26 months)(P>0.05). The median disease-free survival time in patients with significant tumor regression(30.5 months) was longer than that in patients with no significant tumor regression(25 months)(P<0.05). Conclusion Docetaxel+oxaliplatin+S-1/capecitabine in neoadjuvant chemotherapy for advanced gastric cancer could improve the clinical effective rate, surgical resection rate, R0 resection rate and significant tumor regression rate,
作者
毕桢干
李凡周
王培红
唐勇
BI Zhengan;LI Fanzhou;WANG Peihong;TANG Yong(Department of Gastroenterology,Cancer Hospital Affiliated to Xinjiang Medical University,Urumqi 830011,China)
出处
《中华实用诊断与治疗杂志》
2020年第2期199-202,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
新疆维吾尔自治区自然科学基金(2016D01C362).
