潜在可切除胃癌新辅助化疗的临床疗效观察

目的探讨潜在可切除胃癌新辅助化疗的临床疗效。方法收集本科收治的进展期及局部晚期潜在可切除胃癌患者31例,予以改良DCF方案（mDCF）化疗2～4个周期,观察其临床疗效及不良反应。结果全组获CR1例,PR15例,SD10例,PD5例,临床有效率为51．61％,疾病控制率为83．86％。手术切除率为64．52％（20／31）,其中R0切除率为45．16％（14／31）,R1切除率为12．90％（4／31）,R2切除率为6．45％（2／31）。姑息性手术7例（22．58％）。2例术后出现并发症,并发症发生率为10％（2／20）。主要不良反应为骨髓抑制、恶心呕吐及轻度肝功能损害,经对症处理后均可缓解及恢复。结论改良DCF方案应用于潜在可切除胃癌的新辅助化疗的临床疗效较好,该疗法可使肿瘤降期,增加手术切除的机会,化疗相关不良反应可耐受,安全性较高。

Therapeutic efficacy of neoadjuvant chemotherapy for potentially resectable gastric cancer

Objective To evaluate the efficacy and toxicity of neoadjuvant chemotherapy in patients with potentially resectable gastric cancer. Methods A total of 31 patients with potentially advanced gastric cancer were given 2-4 cycles of modified DCF combination therapy involving tegafur,cisplatinum, and docetaxel every three weeks. Clinical efficacy and toxicity were evaluated after every two cycles of chemotherapy. Results Of the 31 patients, 1 responded completely, 15 responded partially, 10 showed stable disease and 5 progressive disease.The most frequent toxic effects associated with neoadjuvant treatment were myelosuppression, nausea and vomiting, and mild hepatic dysfunction. However,these effects were relieved after symptomatic treatment.In addition to chemotherapy, 14 patients were treated surgically using RO resection;4,R1 resection;2,R2 resection.No mortality was associated with the surgeries. Conclu- sions Neoadjuvant chemotherapy appears safe and effective in patients with potentially reseetable gastric cancer. It can result in tumor downstaging, which increases the possibility of surgical resection.