摘要
目的:研究多西他赛联合S-1(docetaxel plus S-1,DS)方案新辅助治疗可切除进展期胃癌的有效性.方法:收集220例可切除的局部进展期胃癌患者的临床资料,随机分为两组,A组和B组.A组患者在第1天静脉滴注多西他赛(35 mg/m2)持续2 h,第1-14天每天口服S-1[80 mg/(m2?d)],4 wk进行2个疗程,期间给予基本止吐药物预防不良反应,而后进行D2胃癌根治术,B组患者仅进行D2胃癌根治术.对两组患者的R0切除率,病理完全缓解率,术后并发症发生率和生存期进行比较和分析.结果:该研究未见治疗相关死亡病例.因为经济原因,107例患者(97.3%)化疗后进行了手术治疗.两组患者吻合口瘘(1.8%v s2.7%,P>0.05)和切口愈合不良(5.6%vs 4.5%,P>0.05)发生率差异无统计学意义,R0切除率(99.06%vs 92.73%,P<0.05)、病理完全缓解率(8.41%vs 1.81%,P<0.05)、复发率(18.6%vs31.8%,P<0.05)、3年生存率(55.7%vs 40.6%,P<0.05)和5年生存率(31.3%vs 21.8%,P<0.05)差异有统计学意义.结论:患者可以很好耐受DS方案,对于可切除的局部进展期胃癌患者,DS方案新辅助化疗可以提高R0切除率和术后病理完全缓解率,增加生存率,降低术后3年内复发率,并不增加术后并发症的发生率,DS方案是可切除进展期胃癌新辅助化疗的有效方案.
AIM： To evaluate the efficacy of preoperative chemotherapy with docetaxel plus S-1（DS regimen） for resectable advanced gastric cancer. METHODS： Two hundred and twenty patients with operable locally advanced gastric cancer were collected and equally divided into two groups（A and B）. In group A, patients received docetaxel（35 mg/m2） on day 1 for 2 h and daily oral administration of S-1 [80 mg/（m2？d）] on days 1-14 every 4 wk for two cycles, and prophylactic administration of antiemetic medication at a standard doses was routinely used to prevent nausea and vomiting. Then gastrectomy with D2 lymphadenectomy was performed. In group B, patients received only gastrectomy with D2 lymphadenectomy. The R0 resection rate, pathological complete response（p CR）, postoperative complications, local recurrence rate and survival rate were compared between the two groups. RESULTS： Treatment-related death or operative mortality was not found in this study. Because of economic reasons, only 107（97.3%） patients underwent surgery. There was no significant difference in the incidence of anastomotic leakage（1.8% vs 2.7%, P 〉 0.05） or poor healing of incision（5.6% vs 4.5%, P 〉 0.05）. There were significant differences in R0 radical resection rate（99.06% vs 92.73%, P 〈 0.05）, p CR rate（8.41% vs 1.81%, P 〈 0.05） and local recurrence rate（18.6% vs 31.8%, P 〈 0.05） between the two groups. The 3-（55.7% vs 40.6%, P 〈 0.05） and 5-year survival rates（31.3% vs 21.8%, P 〈 0.05） also differed significantly between the two groups. CONCLUSION： DS regimen as neoadjuvant chemotherapy for operable locally advanced gastric cancer can increase the rates of R0 radical resection, p CR and survival, and decrease the recurrence rate, without increasing the rate of complications.
出处
《世界华人消化杂志》
CAS
北大核心
2014年第34期5334-5338,共5页
World Chinese Journal of Digestology
关键词
胃癌
新辅助化疗
多西他赛
S-1
生存率
Gastric cancer
Neoadjuvant chemotherapy
Docetaxel
S-1
Survival rate
