进展期胃癌患者FOLFOX4与XELOX新辅助化疗的临床观察

目的：观察FOLFOX4和XELOX新辅助化疗方案对局部进展期胃癌的近期治疗效果以及毒副反应。方法：将2006年7月至2007年8月70例进展期胃癌患者随机分为3组,FOLFOX4新辅助化疗组25例,XELOX组20例,单纯手术组25例。新辅助化疗组行术前化疗2个疗程,化疗结束后4周进行胃癌根治术;单纯手术组行胃癌标准根治术（D2或D2＋）。结果：FOLFOX4组总有效率为52.0%,XELOX组总有效率为55.0%（P〉0.05）。FOLFOX4组恶心、呕吐、白细胞减少和口腔黏膜炎等毒副反应发生率高,而XELOX组以上毒副反应发生率低,仅表现为轻度的手足综合征。新辅助组患者根治性手术切除率为88.9%,单纯手术组为72.0%（P〈0.05）。结论：作为胃癌的新辅助化疗方案XELOX组与FOLFOX4组相似,进展期胃癌患者在新辅助化疗后,再进行手术治疗,可以提高手术根治率和切除率,但XELOX方案毒副作用较轻,化疗时间短,对机体损伤小,易于接受。

Clinical report of neoadjuvant chemotherapy of FOLFOX4 and XELOX for the preoperative patients with advanced gastric cancer

Objective：To observe the recent effects and toxicity in advanced gastric carcinoma by neoadjuvant chemotherapy FOLFOX4 and XELOX.Methods：From Jul 2006 to Aug 2007 in Qingdao Municipal Hospital,a total of 70 patients with advanced gastric cancer,they were randomly divided into 3 groups;neoadjuvant chemotherapy FOLFOX4 group（25 cases）,neoadjuvant chemotherapy XELOX group（20 cases）,surgical group（25 cases）.In neoadjuvant chemotherapy group,patients were given 2 cycles of FOLFOX or XELOX chemotherapy preoperatively,and then received radical gastrectomy 4 weeks after chemotherapy.In operation group,patients were given radical gastrectomy directly（D2 or D2＋）.Results：The total effective rate in group FOLFOX4 was 52.0%,while it was 55.0% in group XELOX,it had no significantly difference compared in two groups（P0.05）.The incidence of nausea,vomiting,neutropenia and oral mucositis was higher in group FOLFOX4.The incidence of hand-foot syndrome was higher in group XELOX.The curative resection rate in neoadjuvant chemotherapy group was 88.9%,while it was 72.0% in surgical group（P0.05）.Conclusion： FOLFOX4 and XELOX as neoadjuvant chemotherapy are similar.The overall resectability rate and the curative resection rate are increased in patients with advanced gastric cancer after neoadjuvant chemotherapy,but the program XELOX had less side effects with short chemotherapy time and less damage to body.