摘要
目的 探讨胃癌术后放化疗的临床意义、治疗方法和毒副反应。方法 将 1995～ 1998年 10 6例晚期胃癌 (ⅢB～Ⅳ期 )根治术后的病人随机分为 :常规放射治疗组 (单放组 ) 5 3例 ,术后高危区域常规外照射总量DT5 4Gy ,每次 1 8Gy ,每周 5次 ,均采用 8MVX线照射 ;综合组 5 3例 ,外照射同常规放射治疗组 ,放射治疗当日及外照射达DT4 0Gy时 ,同时合并化疗。化疗方案 :5 氟尿嘧啶 (5 FU) 5 0 0mg/d ,5d ;亚叶酸钙 (CF) 2 0 0mg/d ,5d。 结果 全部病人随访 5年以上 ,随访率 96 2 %。局控率综合组和单放组分别为 5 8 5 %和 4 1 5 % (P >0 0 5 ) ;综合组和单放组的 1、3、5年生存率分别为 :81 1%、5 0 9%、34 0 %和 6 9 8%、35 9%、2 0 8%。 3、5年生存率差异有显著性 (P <0 0 5 )。综合组的毒副反应高于单放组。结论 晚期胃癌 (ⅢB～Ⅳ期 )根治术后放疗合并 5 FU加CF化疗优于单纯术后放疗 。
Objective To explore the clinical significance ,treatment method and toxic ,side effects of radiochemotherapy after resection of late-stage gastric adenocarcinoma. Methods During 1995～1998,106 cases of late-stage gastric carcinoma (ⅢB～Ⅳ) were randomly divided into 2 groups. Treatment group of regluar radiation (n=53) were given total radiation amount D T 54Gy in high danger area after operation, each time 1.8Gy,5 times each week;all were radiated by 8MVX .Comprehensive group (n=53),external radiation was the same as that of treatment group of regular radiation ,meanwhile chemotherapy was combined. Chemotherapy schedule : 5-FU 500mg/d ,5d,CF200mg/d ,5d .Results All patients were followed up for over 5 years ,the rate being 96.2%.Local control rates of comprehensive group and regular radiation group were 58.5% and 41.5% respectively(P >0.05).The 1,3 and 5 years' survival rates of comprehensive group and regular radiation group were 81.1%,、50.9%,34.0% and 69.8%,35.9%,20.8%,respectively.There was obvious difference between the survival rate of 3 and 5 years (P<0.05 ).The toxic and side-effects of comprehensive group were higher than those of regular radiation group .Conclusion Radiotherapy combined with 5-FU and CF chemotherapy is better than postoperative radiotherapy alone in postoperative management of late-stage gastric adenocarcinoma (stage ⅢB～Ⅳ).
出处
《中国实用外科杂志》
CSCD
北大核心
2004年第6期369-370,共2页
Chinese Journal of Practical Surgery
