局部进展期胃癌术后同步放化疗的临床分析

为了观察局部进展期胃癌术后同步放化疗的疗效及不良反应,对74例局部进展期胃癌术后患者,随机分为对照组和观察组各37例,对照组单纯采用奥沙利铂、亚叶酸钙联合5-氟尿嘧啶辅助化疗；观察组采用同步放化疗,放射治疗采用6MVX线,放射总剂量30～40 Gy/(3～5周).结果观察组的1、2和3年生存率分别为75.7％、64.9％和54.1％,对照组为67.6％、43.2％和27.0％,差异有统计学意义,x2=16.81,P=0.02.观察组的3年无瘤生存率(59.6％)显著高于对照组(21.6％),x2=11.62,P=0.03.不良反应主要为骨髓抑制和胃肠道反应,观察组胃肠道反应的发生率显著高于对照组,x2 =7.94,P=0.01.初步研究结果提示,术后同步放化疗可以提高局部进展期胃癌患者的生存率,且不良反应可耐受,值得在临床借鉴.

Locally advanced gastric cancer after concurrent chemoradiotherapy for clinical analysis

To observe the clinical effectiveness of postoperative chemotherapy combined with radiotherapy for limited advanced gastric carcinoma.Seventy-four cases of the patients were randomly divided into test group and control group,37 cases in each group.The control group was treated with chemotherapy only,the agents was Oxaliplatin,Calcium Folinate and fluorouracil.The test group was treated with chemotherapy and radiotherapy(6 MV X,30-40 Gy/3-5 w).The test group’s survival rate were 75.7%,64.9%,54.1% in recent 3 years,the control group were 67.6%,43.2%,27.0%.The comparisons of two groups were significantly different(χ2=16.81,P=0.02).The test group’s 3 years free survival rates was significantly higher than that in control group(59.6% vs 21.6%,χ2=11.62,P=0.03).The major toxic effects were myelosuppression and gastrointestinal side effects.The incidence rates of gastrointestinal side effects in test group was significantly higher than that in control group(χ2=7.94,P=0.01).In conclusion,chemotherapy and radiotherapy can increase the survival rate in patients with radical surgery for progressing gastric carcinoma,and the adverse reaction can be tolerated.