进展期胃癌应用SOX方案新辅助化疗对手术相关并发症的影响

目的 评估AJCCⅡ～Ⅲ期进展期胃癌应用替吉奥胶囊联合注射用奥沙利铂（SOX方案）新辅助化疗对术后相关并发症发生率的影响.方法 回顾性研究分析解放军总医院普通外科2012年2月～2013年9月收治入组的170例进展期胃癌临床病例资料.研究分为新辅助组（实验组）和单纯手术组（对照组）.新辅助组80例胃癌患者分别予以2～4个周期SOX方案新辅助化疗并进行外科手术.单纯手术组（对照组）为90例直接进行外科手术患者,对新辅助化疗疗效和术后并发症的发生情况进行综合并进行统计学分析.结果 实验组患者对比临床和病理学TNM分期,肿瘤降期明显（P＜0.05）.实验组患者手术时间和失血量较对照组相比,分别具有统计学差异（P =0.017;P=0.05）.两组术后并发症发病率无统计学差异（P＝0.704）,其中在最为关注的手术相关并发症中,吻合口瘘的发生率无统计学差异（0％ vs 2.2％,P＝0.499）;术后出血发生率亦相近（3.8％vs1.1％,P =0.343）.结论 进展期胃癌应用SOX方案新辅助化疗后肿瘤降期明显,并不会提高术后并发症的发生.

Complications after Radical Gastrectomy with SOX Neoadjuvant Chemotherapy for Advanced Gastric Cancer

Objective To evaluate the impact of S-1 combined with oxaliplatin （SOX regimen） as neoadjuvant chemotherapy on the morbidity of related complications after radical gastrectomy.Methods We randomly assigned 80 patients to the neoadjuvant group and 90 patients to surgery-alone group from February 2012 to September 2013.The patients in the neoadjuvant group had been received D2 radical gastrectomy after preoperative chemotherapy.In the neoadjuvant group,the treatment was performed 2-4 cycles before surgery.The complications after D2 surgery were statistically analyzed for the patients of two groups.Results There were no differences in the morbidity of complications between neoadjuvant and surgery alone groups （P =0.704）.For the significant surgical complications,the incidence of anastomic fistula was of no difference between two groups （0％ vs 2.2％,P =0.499）.Also,the morbidity of postoperative hemorrhage was similar （3.8％ vs 1.1％,P =0.343）.Conclusion SOX regimen as neoadjuvant chemotherapy did not impove postoperative morbidity compared with surgery alone.