不同给药途径的新辅助化疗对胃癌患者的术前影响

目的新辅助化疗在胃癌的治疗中占有重要地位,不同给药途径的化疗方案在疗效以及化疗不良反应上存在较大差别。文中探讨术前动静脉结合的新辅助化疗对胃癌患者的术前影响。方法 32例临床诊断为Ⅲ、Ⅳ期的局部进展期胃癌患者接受术前动静脉结合的FLEEOX方案:氟尿嘧啶370 mg/m2,缓慢静脉滴注,第1至第5天;亚叶酸钙200 mg,静脉滴注,第1至第5天;奥沙利铂120mg/m2、表柔比星30mg/m2、足叶乙甙70mg/m2,动脉介入注射到癌肿所在部位,第6、20天,每5周重复1次,共治疗2个疗程。同期收治的18例Ⅲ、Ⅳ期局部进展期胃癌患者接受XELOX方案:奥沙利铂130mg/m2,4h内静脉滴注,第1天;口服卡培他滨850 mg/m2,2次/d,持续2周,每3周重复1次,共治疗2个疗程。根据美国国家癌症研究所CTC3.0版标准评价化疗毒性反应,观察比较不同治疗方案对胃癌患者生活质量、不良反应、临床症状及营养状况等影响。结果 FLEEOX组患者化疗后的前清蛋白、体重指数(body mass index,BMI)均显著高于XELOX组患者;进食哽咽、食欲不振等临床症状也较XELOX组患者有明显改善;在肝肾功能损害、骨髓造血功能抑制、恶心、呕吐等化疗相关毒性反应方面,2组患者差异无统计学意义。结论 2组进展期胃癌患者均可耐受新辅助化疗方案的毒性反应。FLEEOX方案可更加有效地改善肿瘤患者营养状况及相关临床症状,提高术前的生活质量。

Effects of different routes of neoadjuvant chemotherapy on gastric cancer patients before operation

Objective Neoadjuvant chemotherapy plays an important role in the treatment of gastric cancer.Different routes of medication produce different therapeutic effects and adverse events in chemotherapy.This study was to evaluate the effects of combined preoperative intraarterial infusion and intravenous chemotherapy on gastric cancer patients before operation.Methods A total of 32 patients with clinical stage Ⅲ-Ⅳ gastric cancer received combined preoperative intraarterial infusion and intravenous chemotherapy,the FLEEOX regimen: 5-Fluorouracil 370 mg/m2,iv on day 1-5;Leukovorin 120 mg/m2 on day 1-5;oxaliplatin 150 mg/m2,epirubicin 30 mg/m2 and Epotoside 70 mg/m2,ia on day 6 and 20.Another 18 patients with clinical stage Ⅲ-Ⅳ gastric cancer underwent the XELOX regimen: intravenous drip of oxaliplatin 130 mg/m2 for 4 hours on day 1;oral Capecitabine 850 mg/m2 bid for 2 weeks.Both of the groups were treated for two courses.The effects of different routes of neoadjuvant chemotherapy concerning the patients′ quality of life(QOL) and nutritional status,clinical symptoms,and chemotherapeutic toxicity were evaluated by NCI CTC 3.0.Results The FLEEOX group showed significantly higher concentration of prealbumin and body mass index as well as more alleviated dysphagia and inappetency than the XELOX group,but there were no significant differences in liver and renal impairment,hematopoietic depression,nausea and vomiting between two groups.Conclusion Both the toxicity of FLEEOX and that of XELOX are tolerable,and but the former is better in improving the nutritional status,QOL and clinical symptoms of gastric cancer patients.