FOLFOX、XELOX方案联合腹腔镜治疗进展期胃癌的研究

背景:单一的手术、放疗、化疗对进展期胃癌疗效均欠佳,近年来多学科协作诊治模式(MDT)越来越受重视。目的:探讨术前FOLFOX、XELOX化疗方案联合腹腔镜治疗进展期胃癌的疗效。方法:纳入2009年2月~2013年2月新疆生产建设兵团第一师医院和新疆生产建设兵团医院收治的进展期胃癌患者,给予FOLFOX或XELOX化疗方案联合腹腔镜胃癌D2根治术,对两种治疗方案的疗效进行比较分析。结果:共54例患者纳入研究,FOLFOX组29例,XELOX组25例。化疗后临床完全缓解(CR)7例,部分缓解(PR)23例,疾病稳定(SD)15例,疾病进展(PD)9例,总有效率(RR)为55.6%(30/54),FOLFOX、XELOX组间疗效差异无统计学意义(P0.05)。XELOX组患者恶心、呕吐、骨髓抑制以及腹泻的发生率显著低于FOLFOX组(P0.05),口腔黏膜炎、手足综合征的发生率显著高于FOLFOX组(P0.05)。45例患者经腹腔镜切除肿瘤,9例患者行腹腔镜探查术,未切除肿瘤,FOLFOX、XELOX组间手术切除率差异无统计学意义(P0.05)。FOLFOX、XELOX组术后病理分期均较治疗前显著降低(P0.05)。结论:术前FOLFOX、XELOX方案联合腹腔镜治疗进展期胃癌疗效相似,具有良好的有效性和安全性。

Efficacy of FOLFOX and XELOX Chemotherapy Combined with Laparoscopy for Treatment of Advanced GastricCancer

Background： The efficacy of surgery, radiotherapy or chemotherapy alone for advanced gastric cancer is poor. In recent years, muhidisciplinary treatment （MDT） has received more and more attention. Aims： To investigate the efficacy of preoperative FOLFOX and XELOX chemotherapy combined with laparoscopic resection for treatment of advanced gastric cancer. Methods： Patients with advanced gastric cancer from Feb. 2009 to Feb. 2013 at Xinjiang Diyishi Hospital and Hospital of Xinjiang Production ＆ Construction Corps were enrolled and received FOLFOX or XELOX chemotherapy combined with laparoseopie D2 radical gastreetomy. The efficaeies of the two regimens were analyzed. Results： A total of 54 eligible patients were enrolled in this study, 29 in FOLFOX group and 25 in XELOX group. Clinical complete response （CR） occurred in7 patients, partial response （PR） occurred in 23 patients, stable in disease （SD） occurred in 15 patients, and progress in disease （PD） occurred in 9 patients. The overall response rate （RR） was 55.6% （30/54）. No significant difference in therapeutic efficacy was seen between FOLFOX and XELOX groups （ P 〉 0.05 ）. The incidence rates of nausea, vomiting, myelosuppression and diarrhea were significantly lower and the incidence rates of oral mucositis and hand-foot syndrome were significantly higher in XELOX group than in FOLFOX group （ P 〈 O. 05 ）. Tumor was successfully removed by laparoscopic resection in 45 patients and was not removed in 9 patients. No significant difference in resection rate was seen between FOLFOX and XELOX groups （ P 〉 0.05 ）. The histological stages of tumor in both FOLFOX and XELOX groups were significantly decreased after treatment （ P 〈 0.05 ）. Conclusions ： The efficacy of preoperative FOLFOX and XELOX chemotherapy combined with laparoscopic resection was similar for treatment of advanced gastric cancer, and both were safe and effective.