| 摘要: |
| 目的 比较局部进展期胃癌D2根治术后同步放化疗与单纯化疗的疗效和不良反应。方法 选取接受根治术的局部进展期胃癌患者79例(R0切除,D2淋巴结清扫),随机分为2组。试验组40例,采用放疗同步卡培他滨化疗序贯4周期奥沙利铂联合卡培他滨(XELOX)方案化疗。对照组39例,术后仅予以6周期奥沙利铂联合卡培他滨(XELOX)方案化疗。比较两组患者局部复发率、3年无病生存率、3年总生存率及不良反应。结果 与对照组比较,试验组局部复发率降低[64.1%(25/39) vs 40.0% (16/40),P=0.032],3年无病生存率和3年总生存率比较有所增高,但差异无统计学意义(P>0.05);试验组和对照组淋巴结阳性患者3年生存率分别为45.2%(14/31)和18.5%(5/27)(P=0.049),中位无病生存期分别为26个月和19个月(P=0.024)。试验组血液毒性和胃肠道反应发生率较高。结论 局部进展期胃癌根治术后同步放化疗序贯化疗较单纯化疗可以降低局部复发率,对于淋巴结阳性患者有改善生存的趋势。主要不良反应为血液毒性及胃肠道反应。 |
| 关键词: 胃肿瘤 胃癌根治术 放射疗法 药物疗法 |
| DOI：10.16781/j.0258-879x.2016.02.0177 |
| 投稿时间：2015-01-08修订日期：2015-05-17 |
| 基金项目: |
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| Chemoradiotherapy vs pure chemotherapy for local progressive gastric cancer following D2 lymph node dissection: a comparison of effectiveness |
| YU Jia-wen1,2,HAO Ji-qing1*,HU Zhi-gang3,QIAN Li-ting3 |
(1. Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China;
2. Department of Oncology, The First People's Hospital of Anqing, Anqing 246004, Anhui, China;
3. Department of Radiation Oncology, The Provincial Hospital of Anhui, Hefei 230001, Anhui, China
*Corresponding author) |
| Abstract: |
| Objective To compare the therapeutic effects and adverse reaction of concurrent chemoradiotherapy with pure chemotherapy for local progressive gastric cancer following D2 lymph node dissection. Methods Seventy-nine patients with progressive gastric cancer who underwent R0 gastric resection and D2 lymph node dissection were randomly divided into two groups. After radical gastrectomy, the experimental group (n=40) received radiotherapy concurrent with capecitabine chemotherapy, and then followed by 4 cycles of XELOX chemotherapy; however, the control group (n=39) only received 6 cycles of XELOX chemotherapy. The local recurrence rates, 3-year disease-free survival rates, 3-year overall survival rates and adverse reactions were evaluated after the treatment. Results The local recurrence rate in the experimental group was significantly lower than that of the control group (40.0%[16/40] vs 64.1% [25/39],P=0.032). The 3-year disease-free survival rates and 3-year overall survival rates of the experimental group were higher than those in the control group, but with no significant difference (P>0.05). The 3-year overall survival rate of patients with positive lymph node was significantly higher in the experimental group than in the control group (45.2% [14/31] vs 18.5% [5/27], P=0.049), with their median disease-free survival (mDFS) periods being 26 months and 19 months, respectively (P=0.024). The incidences of hematological and gastrointestinal toxicities in the experimental group were higher than those in the control group. Conclusion Concurrent chemoradiotherapy and chemotherapy can greatly reduce local recurrence after curative resection and D2 lymph node dissection in gastric cancer patients. In patients with lymph node-positive gastric cancer, postoperative concurrent chemoradiotherapy may improve their survival. The main adverse reactions of the concurrent treatment are hematological and gastrointestinal toxicities. |
| Key words: stomach neoplasms radical gastrectomy radiotherapy drug therapy |
