紫杉醇联合奥沙利铂及S-1的新辅助化疗方案对进展期胃癌治疗效果评价

目的:研究紫杉醇联合奥沙利铂及S-1的新辅助化疗方案对进展期胃癌的治疗效果。方法:将2014年1月-2017年6月于上海市第六人民医院胃肠外科和上海市第一人民医院宝山分院普外科进行治疗的63例进展期胃癌患者分为观察组及对照组，分别在术前予以紫杉醇联合奥沙利铂及S-1的新辅助化疗方案以及奥沙利铂+卡培他滨的传统化疗方案，化疗后均行手术治疗。治疗期间记录并比较两组患者化疗效果、化疗不良反应的发生率、CT改变以及R0切除率。最后采用Spearman相关性回归分析化疗副作用与年龄、ECOG评分等一般临床资料上的相关性。结果:观察组的化疗有效率、手术R0切除率均高于对照组（均P<0.05），在化疗毒副作用上，观察组的恶性呕吐及骨髓抑制的发生率均高于传统化疗组（均P<0.05），但不良反应经对症处理均能缓解，不影响手术及后续治疗。Spearman相关性回归分析结果显示，恶性呕吐及骨髓抑制、白细胞减少、血小板减少、贫血与年龄以及ECOG评分呈现正相关关系（均P<0.05）。结论:紫杉醇联合奥沙利铂及S-1的新辅助化疗方案可提高胃癌患者化疗效果，增加手术R0切除率，且化疗安全性可控。

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

Objective:To study the efficacy of neoadjuvant chemotherapy with paclitaxel combined with oxaliplatin and S-1 in locally advanced gastric cancer.Methods:The 63 patients with locally advanced gastric cancer in department of Gastrointestinal Surgery，Shanghai Sixth People's Hospital and General Surgery，Baoshan Branch，Shanghai First People's Hospital were enrolled in the study.The patients were divided into two groups，the observation group(paclitaxel combined with oxaliplatin and S-1) and the control group(oxaliplatin combined with capecitabine)，respectively.During preoperative chemotherapy，the chemotherapy effect，incidence of adverse reactions of chemotherapy and change CT image were also recorded and compared.Finally，Spearman correlation regression was used to find out the correlation between side effects of chemotherapy and general clinical data such as age and ECOG score.Results:The efficiency of chemotherapy and R0 resection rate in the observation group were higher than that the control group(all P<0.05).In the aspect of side effects of chemotherapy，the rate of malignant vomiting and myelosuppression in the observation group were higher than that in the control group(all P<0.05).However，adverse reactions could be alleviated by symptomatic treatment without affecting surgery and follow-up treatment.Furthermore，CT image showed a marked reduction of the tumors.Spearman correlation regression analysis showed that malignant vomiting，myelosuppression，leukopenia，thrombocytopenia and anemia were positively correlated with age and ECOG scores，respectively.Conclusion:Paclitaxel combined with oxaliplatin and S-1 neoadjuvant chemotherapy is safe and controllable，which can improve the chemotherapy effect and R0 resection rate.