XELOX和FOLFOX4新辅助化疗方案治疗局部晚期胃癌的安全性和有效性

目的:探讨XELOX和FOLFOX4新辅助化疗方案治疗局部晚期胃癌的安全性和有效性。方法:选择我院2014年1月至2015年1月收治的局部晚期胃癌患者100例，将患者随机分为观察组（n=50）和对照组（n=50），观察组给予XELOX方案化疗，对照组给予FOLFOX4方案化疗。观察两组患者主要临床结局和不良反应。结果:两组患者2年死亡率和复发率均无统计学差异［(32.00% vs 42.00%,P=0.300)和(70.00% vs 84.00%,P=0.096)］。观察组患者无进展生存期显著长于对照组(P=0.022)。两组患者入院时健康相关的生存质量(SF-36)差异无统计学意义(81.56±6.66 vs 81.58±7.03,P=0.988)。与对照组比较，观察组1个月和3个月后健康相关的生存质量(SF-36)均显著提高［(75.34±6.67 vs 71.66±7.35,P=0.010)和(68.24±6.44 vs 62.68±9.12,P=0.001)］。观察组恶心、呕吐、神经毒性等不良反应显著低于对照组，但手足综合征显著高于对照组，差异均有统计学意义(P＜0.05)。结论:XELOX化疗方案可延长局部晚期胃癌患者无进展生存期，不良反应较少，但手足综合征发生率较高。

Clinical study of safety and efficacy of the neoadjuvant chemotherapy of XELOX and FOLFOX4 in locally advanced gastric cancer

Objective:To explore safety and efficacy of the neoadjuvant chemotherapy of XELOX and FOLFOX4 in locally advanced gastric cancer.Methods:100 patients with locally advanced gastric cancer treated in our hospital from January 2014 to January 2015 were randomly divided into two groups:The observation group（n=50) and the control group（n=50),and the observation group patients received the chemotherapy of XELOX while the control group patients received the chemotherapy of FOLFOX4.The major clinical outcomes and adverse reactions of the two groups patients were observed.Results:The mortality and the recurrence rates of the two group had no statistically significant differences［(32.00% vs 42.00%,P=0.300) and （70.00% vs 84.00%,P=0.096)］.The progression-free survival of the patients in the observation group was significantly longer than that in the control group（P=0.022).The health-related quality of life（SF-36) of the patients in two groups on admission had no statistically significant differences（81.56±6.66 vs 81.58±7.03,P=0.988).Compared with the control group,the health-related quality of life（SF-36) of the observation group at 1 month and 3 months since the admission both increased significantly ［(75.34±6.67 vs 71.66±7.35,P=0.010) and （68.24±6.44 vs 62.68±9.12,P=0.001)］.The occurrence rates of nausea,vomiting,neurotoxicity and other adverse reactions in the observation group were significantly lower than the control group,but the incidence of the hand foot syndrome in the observation group was significantly higher than the control group,and the differences were statistically significant（P＜0.05).Conclusion:XELOX could prolong the progression-free survival of the patients with locally advanced gastric cancer and decrease the incidence of adverse reactions,but increase the incidence of hand foot syndrome.