紫杉醇联合S-1的新辅助化疗方案在局部进展期胃癌中的疗效

目的:评价紫杉醇联合S-1方案的新辅助化疗治疗进展期胃癌的临床疗效及不良反应。方法:回顾性分析2014年7月至2017年7月在上海交通大学附属第六人民医院普外科接受治疗的55例进展期胃癌患者的临床资料。采用Kaplan-Meier法进行生存分析,Cox比例风险模型进行多因素预后分析。结果:新辅助化疗+手术组的R0切除率明显高于常规手术组(P<0.05);新辅助化疗+手术组的不良反应均可经对症处理后缓解,不影响治疗,停药后逐渐恢复。Cox比例风险模型显示:病理反应(P=0.002,RR=0.121,95%CI:0.014~0.453)、影像学疗效(P=0.009,RR=0.212,95%CI:0.076~0.478)和TNM分期(P=0.015,RR=1.712,95%CI:1.021~4.123)是影响新辅助化疗+手术组患者术后复发的独立因素。新辅助化疗+手术组的并发症发生率与常规手术组差异无统计学意义(P>0.05)。结论:紫杉醇联合S-1方案是一个针对进展期胃癌新辅助化疗效果较好而不良反应较小的方案。

Efficacy of neoadjuvant chemotherapy with paclitaxel combined and S-1 in locally advanced gastric cancer

Background:To evaluate the clinical efficacy and adverse effect of the neoadjuvant chemotherapy with paclitaxel and S-1 in the treatment of advanced gastric cancer.Methods:The clinical data of 55 patients with advanced gastric cancer who received treatment in our department from July 2014 to July 2017 were analyzed retrospectively.Kaplan-Meier method was used for survival analysis and Cox proportional hazard model was used for multivariate prognostic analysis.Results:The R0 resection rate of neoadjuvant chemotherapy+surgery group was significantly higher than that of conventional operation group(P<0.05);the adverse reactions of neoadjuvant chemotherapy+operation group were alleviated after symptomatic treatment,without affecting the treatment effect,and gradually recovered after drug withdrawal.The Cox model showed that pathological response(P=0.002,RR=0.121,95%CI:0.014–0.453),clinical imaging(P=0.009,RR=0.212,95%CI:0.076–0.478)and TNM stage(P=0.015,RR=1.712,95%CI:1.021–4.123)were independent factors affecting recurrence of patients in this group.There was no significant difference in the incidence of complications between the neoadjuvant chemotherapy+operation group and the conventional operation group.Conclusion:Paclitaxel combined with S-1 is a good alternative for neoadjuvant chemotherapy of advanced gastric cancer with less adverse effects.