新辅助化疗联合手术治疗进展期胃癌的疗效观察

目的探讨新辅助化疗联合手术治疗进展期胃癌的临床疗效和安全性。方法选取66例进展期胃癌患者,随机分为观察组和对照组,每组33例,观察组患者术前行新辅助化疗(FOLFOX方案)。两组患者均择期进行手术治疗,比较两组患者手术切除效果、术后并发症和生存时间。结果观察组患者均完成新辅助化疗,完全缓解率为24.2%(8/33),总有效率为60.6%(20/33),疾病控制率为84.8%(28/33)。3⁴级不良反应主要为呕吐、肝功能异常、血红蛋白降低、中性粒细胞减少和食欲减退。观察组患者的手术根治性切除率为75.8%(25/33),显著高于对照组(51.5%,17/33);住院时间低于对照组,差异有统计学意义(P<0.05)。观察组患者并发症发生率为21.2%(7/33),低于对照组(24.2%,8/33),但差异无统计学意义(P>0.05)。结论进展期胃癌患者进行新辅助化疗可有效提高根治率,减少手术并发症,值得临床进一步推广。

Efficacy of neoadjnvant chemotherapy combined with surgery in patients with advanced gastric car- cinoma

Objective To observe the efficacy of neoadjuvant chemotherapy combined with surgery in patients with advanced stomach neoplasms. Methods 66 patients with advanced stomach neoplasms were randomly divided into observation group （33 cases ） and control group （33 cases ）. The observation group underwent neoadjuvant chemotherapy （FOLFOX regimen） before surgery. The surgical resection re- sults, complications and postoperative survival time were compared between the two groups. Results The patients of observation group had completed chemotherapy. Complete remission rate, effective rate and dis- ease control rate were 24. 2% , 60. 6% and 84. 8% , respectively. The main adverse reactions were nausea, abnormal liver function, anemia, neutropenia and loss of appetite. Radical resection rate of observation group （75.8%） was significantly higher than that in control group （51.5%）. The hospitalization time was shorter than the control group （ P 〈 0. 05 ）. The incidence of complications of observation group （ 21.2% ） was smaller than those of the control group （24. 2% ）. There was no significant difference （Z2 = 1. 2641 , P 〉 0. 05 ） between the two groups. Conclusions Neoadjuvant chemotherapy can enhance the cure rate of advanced stomach neoplasms, reduce complications. It is worthy of further promotion.