摘要
目的 评价多西他赛联合替吉奥同步调强放疗新辅助治疗局部进展期胃癌的近、远期疗效和毒性不良反应.方法 对84例病理学证实的局部进展期胃癌采用多西他赛联合替吉奥同步调强放疗方案进行治疗,放化疗结束后3周进行手术前影像学评估,符合条件的病例并接受手术治疗.结果 放化疗有效率为65.5％,R0切除率为87.0％（67/77）,病理反应率为81.8％（63/77）,pCR率为11.7％ （9/77）.无围术期死亡,术后并发症发生率为14.3％ （11/77）.随访率为100％,手术后患者的1、2、3年的生存率、无局部/区域复发生存率以及无转移生存率分别为81.8％ （63/77）、62.3％ （48/77）和45.5％（48/77）,81.8％（63/77）、64.9％ （50/77）和53.2％（41/77）,85.4％（65/77）、74.0％ （57/77）和57.9％（46/77）.新辅助放化疗的不良反应多为1～2度反应,其中3～4度血液学毒性累计：白细胞减少14.3％,血红蛋白减少4.8％,血小板减少4.8％,恶心、呕吐为9.5％,腹泻为6.0％,食欲下降为7.1％,大部分患者可以耐受.结论 多西他赛联合替吉奥同步调强放疗新辅助治疗局部进展期胃癌近期疗效高,R0切除率高,3年生存率较理想,不良反应可耐受,安全性好.
Objective To investigate the efficacy and side effect of neoadjuvant chemoradiotherapy with docetaxel and S - 1 in pa- tients with locally advanced gastric carcinoma. Methods Totally 84 patients with pathology -proved locally advanced gastric carcinoma received chemoradiotherapy with docetaxel and S - 1. Patients with surgical indications by imaging evaluation underwent radical surgery in 4 weeks after chemoradiotherapy. Results The overall response rate of chemoradiotherapy was 65.5% and the complete resection rate was 87.0%. The pathologic response rate and the complete pathologic response rate were 81.8 % and 11.7% respectively. There were no postoperative deaths and the incidence of postoperative complications was 14.3%. The follow - up rate was 100%. The 1 - , 2 - and 3 - year overall survival rate were 81.8% , 62.3% and 45.5% ,the locoregional relapse-free survival rate 81.8% , 64.9% and 53.2% ,and distant metastasis - free survival rate 85.4% ,74.0% and 57.9%. The Side effects of chemoradiotherapy were mostly grade 1 or 2. The overall leucopenia, hemoglobin decreased, thrombocytopenia, nausea and vomiting, diarrhea and loss of appetite in grade 3 and 4 was 14. 3% , 4.8% , 4.8% , 9.5% , 6.0% and 7.1%. Most patients could tolerate adverse reactions. Conclusion Neoadjuvant chemora- diotherapy with docetaxel and S - 1 in patients with locally advanced gastric carcinoma can achieve fine clinical efficacy and complete re- section rate, so as to 3 -year overall survival rate. The side effect is clinically acceptable.
出处
《医学研究杂志》
2015年第1期132-135,共4页
Journal of Medical Research
关键词
进展期胃癌
新辅助疗法
多西他赛
替吉奥
不良反应
预后
Advanced gastric carcinoma
Neoadjuvant chemotherapy
Docetaxel
S - 1
Side effect
Prognosls
