术前冲击化疗治疗进展期胃癌

目的 探讨术前冲击化疗对进展期胃癌的有效性及安全性.方法 将108例进展期胃癌患者随机分为两组,观察组(54例)采用改良FOLFOX7方案化疗2周期后行手术治疗,术后再给予6个周期FOL-FOX7化疗,对照组(54例)采用常规手术治疗,术后给予8周期的FOLFOX7辅助化疗.比较分析两组的疗效,术后1、2、3年的生存率与不良反应发生率.结果 观察组总有效率、根治性切除率、总切除率分别为59.3％、81.5％、90.7％,均高于对照组的35.2％,59.3％,75.9％(x2=8.55、6.39、4.27,均P＜0.05).两组术后1、2年生存率差异均无统计学意义(x2=0.38、2.06,均P＞0.05),而观察组术后3年生存率显著高于对照组(x2 =4.06,P＜0.05).两组不良反应发生率差异无统计学意义(P＞0.05).结论 进展期胃癌采用改良FOLFOX7方案行术前冲击化疗安全有效,可提高手术根治性切除率及术后的生存率,耐受性良好.

The preoperative impact chemotherapy for advanced gastric cancer

Objective To explore the effect and safety of preoperative impact chemotherapy in the treatment of advanced gastric cancer patients. Methods 104 patients with advanced gastric cancer were randomly divided into two groups, including 54 cases of observation group ,54 cases of control group. The observation group was given modi- fied FOLFOX7 regimen for 2 courses before operation, and 6 courses FOLFOX7 regimen after operation. The control group was given routine operation and FOLFOX7 regimen for 8 courses. The effective rate, 1-year, 2-year, 3-year sur- vival rate and toxic effects after operation were observed. Results In observation group, the effective rate was 59. 3% , the curative resection rate was 81.5% , and the overall resectability rate was 90. 7% , and those was 35.2% , 59.3% , 75.9% in control group, all the difference was statistically significant（ X2 = 8.55,6.39,4.27, all P 〈 0.05 ）. The 1 -year ,2-year survival rates after operation were not significantly different （ ~2 = O. 38,2.06, all P 〉 O. 05 ） , while the difference was significant at 3-year after operation（ X2 = 4.06, P 〈 O. 05 ）. There was no significant difference on the toxic effects between the two groups （ P 〉 0.05 ）. Conclusion Modified FOLFOX7 regimen is effective and well-tolerable for patients with advanced gastric cancer, and it could contribute to improve the overall re- sectability rate and survival rate after operation.