不能切除进展期胃癌新辅助化疗的评价：临床,组织学效果

目的　为探讨进展期胃癌新辅助化疗 ( NACT)效果。方法对 11例不能切除高度进展期胃癌采用新的辅助化学疗法 ,即术前化疗 ,应用 5-氟尿嘧啶顺铂 ( 5- Fu/ CDDP)或卡铂 ( CBDCA)方案 ,5-Fu750 mg/ m2、CDDP60 mg/ m2或 CBDCA4 0 0 mg/ m2动脉、腹腔给药 1～ 2个疗程。结果　临床效果 :完全缓解 ( CR) 0例 ,部分缓解 ( PR) 8例 ,无变化 ( NC) 3例 ,进展 ( PD) 0例 ,有效率 72 .7% ( 8/ 11) ,腹水消失有效率 85.7% ( 6/ 7)。PR8例中 ,手术切除 7例 ,占 63.6% ( 7/ 11)。组织学效果 :轻度有效 ( a) 3例 ,中度有效 ( b) 3例 ,显著有效 ( ) 1例。副作用主要是骨髓抑制 ,2～ 3周可恢复。 7例术后 5- FuCDDP或 CBDCA辅助化疗 1～ 2个疗程 ,除 1例术后 3个月死于肠梗阻外 ,其余 6例生存 ,一般状态( PS) 0～ 2级。结论新辅助化疗作为高度进展期胃癌综合治疗一部分 ,对改善病期 ,使不可能手术患者变为可能手术 ,提高手术切除率能发挥重要作用。

Evaluation of a novel adjuvant chemotherapy for non-resectable advanced gastric cancer

Objective To evaluate the effects of a novel adjuvant chemotherapy for the patients with advanced gastric cancer.Methods Preoperative chemotherapy with 5 Fluorouracil and cisplatin(5 FU CDDP) was performed on 11 cases of nonresectable for advanced gastric cancer.The therapy comprised of either intravenous or arterial infusion or intraperitoneal administration of 5 Fu 750mg/m 2 and CDDP 60mg/m 2 or(CBDCA 400mg/m 2),for 1 2 courses.Results There was no CR,the PR,NC occurred in 8,and 3 cases respectively.There was no disease progression seen.The overall response rate was 72.7%(8/11)and ascites disappeared in being 85.7%(6/7)of the treated cases.7 of the 8 PR cases were operated.Histologically the effects of the chemotherapy was considered as slight,moderate and marked in 3,3 and 1 cases,respectively.Side effects were mainly bone marrow suppression which recovered in two to three weeks.These 7 cases recieved additional 1 2 courses of chemotherapy postoperatively,one patients died of intestinal obstruction.Conclusion The adjuvant chemotherapy reported here as a part of combination therapy plays a significant role in the effective treatment of otherwise nonresectable gastric cancer patients.