改良FOLFOX7方案对Ⅲ期胃癌新辅助化疗的临床观察

目的观察Ⅲ期胃癌患者行改良FOLFOX7方案新辅助化疗的临床疗效及不良反应。方法 分析2008年1月—2010年12月收治的71例Ⅲ期胃癌患者的临床资料,其中新辅助化疗组41例,单纯手术组30例。新辅助化疗采用改良FOLFOX7方案(奥沙利铂100mg/m~2+甲酰四氢叶酸钙400 mg/m~2+5-氟尿嘧啶2400 mg/m~2)化疗2～4周期后评估新辅助化疗临床疗效及不良反应,并行手术。单纯手术组行标准胃癌根治术。结果新辅助化疗结束后,临床总有效率为53.66%(22/41),临床分期降低26.83%(11/41),根治性切除(RO)90.24%(37/41);单纯手术组根治性切除(RO)66.66%(20/30),2组比较差异有统计学意义(P<0.05)。改良FOLFOX7方案常见不良反应主要为恶心呕吐75.61%(31/41)、手足综合征29.27%(12/41)、白细胞减少80.49%(33/41)和贫血21.95%(9/41),大多为Ⅰ～Ⅱ级,无化疗相关死亡。结论改良FOLFOX7方案在Ⅲ期胃癌新辅助化疗中,临床总有效率较高,肿瘤降期明显,根治性切除率提高,且患者耐受良好。

Clinical observation of neoadjuvant chemotherapy of modified FOLFOX7 scheme for stageⅢgastric cancer

Objective To observe the efficacy and toxicity of modified FOLFOX7 scheme neoadjuvant chemotherapy in patients with stageⅢgastric cancer.Methods Retrospective reviewed and analyzed the clinical data of 71 patients with stageⅢgastric cancer who had been admitted from January 2008 to December 2010.They were randomly divided into neoadjuvant chemotherapy group(41 cases) and surgical group(30 cases).In the neoadjuvant chemotherapy group,patients were given modified FOLFOX7 scheme(xaliplatin 100 mg/m~2 + calcium folinate 400 mg/m~2 + 5-fluorouracil 2400 mg/m~2) for 2 to 4 weeks and then received the operation after evaluation of the efficacy and toxicity of neoadjuvant chemotherapy.In operation group,patients were given radical gastrectomy.Results In the neoadjuvant chemotherapy group,the clinic efficacy rate(CR+ PR) was 53.66%(22/41);the clinic decrease stage rate was 26.83%(11/41);radical resection rate(R0) was 90.24% (37/41),compared with 66.66%(20/30) in operation group there were significant differences(P< 0.05).The common toxicities of modified FOLFOX7 scheme were nausea/vomiting 75.61%(31/41),hand foot syndrome 29.27%(12/41),leukocytopenia 80.49%(33/41) and anemia 21.95%(9/41),which were most in gradeⅠorⅡ.There was no chemotherapy related deaths.Conclusion Modified FOLFOX7 regimen is effective and with good tolerance for patients with stageⅢgastric cancer.