摘要
目的比较术前放化疗与术后放化疗治疗局部晚期胃癌的疗效和不良反应。方法将局部晚期胃癌患者52例随机分为:试验组(术前放化疗+手术组)26例,行2周期XP方案[顺铂60 mg/m2第1天+卡培他滨1 000 mg/(m2·次)(2次/d,第1～14天),每3周为1个周期],之后行卡培他滨同期放疗45 Gy/25F;对照组(手术+术后放化疗组)26例,手术后行2周期XP方案化疗,之后行卡培他滨同步放疗,再行2方案化疗。评价两组的不良反应,并随访比较1年无病生存期(DFS)和1年总生存(OS)。结果试验组的1年DFS优于对照组,差异有统计学意义(P=0.038);试验组的1年OS不优于对照组,差异无统计学意义(P=0.457);试验组发生Ⅲ度腹痛、Ⅲ度白细胞下降要低于对照组,差异有统计学意义(P=0.006,P=0.045)。结论局部晚期胃癌术前放化疗比术后放化疗改善无进展生存,但不能延长总生存。术前放化疗发生不良反应要低于术后放化疗。局部晚期胃癌行术前放化疗是否能得到更好的疗效,需要更大规模的临床试验来验证。
Objective To compare the chemotherapy curative effect and the adverse reaction on locally ad vanced gastric cancer between the treatment ofpreoperative chemoradiation and adjuvant radiation.Methods Fifty two patients with locally advanced gastric cancer were randomly divided into the experiment group(preoperative chemoradiation plus surgery)and the control group(surgery plus postoperative radiation and chemotherapy).Twenty-six patients in the experiment group received first 2 cycle XP scheme of chemotherapy[(cisplatin 60 mg/m^2,day1+capecitabine 1 000 mg/m(2 2 times/d,1~14 d,every three weeks for a cycle)],followed with of capecitabine in the same period radiotherapy 45 Gy/25F;Twenty-six patients inthe control group received line 2 cycle XP scheme che motherapy after surgery and line of capecitabine in the same period radiotherapy 45 Gy/25 Fafter 2 cycles of XP scheme of chemotherapy.Adverse reaction of patients in two groups were evaluated,,followed up with 1-year dis ease-free survival(DFS)and overall survival(OS).Results The 1-year DFSin theexperiment group was better than that in the control group with significant difference(P=0.038).The 1-year OS in theexperiment group was not supe rior than that in the control group(P=0.457).TheⅢabdominal pain,Ⅲdegree of WBC decline in the experiment group were significantly declined compared with the control group(P=0.006,P=0.045).Conclusions The preop erative chemoradiation of locally advanced gastric cancer was better than postoperative chemoradiation,with im provement of progression-free survival,but always not prolonging the overall survival.The adverse reactions of the preoperative chemoradiothearpy was lower than that of the postoperative chemoradiation.Whether preoperative chemoradiation of locally advanced gastric cancer can get better curative effect need more large-scale clinical trials to be performed.
作者
马雄辉
官成浓
MA Xionghui;GUAN Chengnong(The Second Clinical Medical College of Guangdong Medical University,Dongguan 523808,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第2期271-275,共5页
The Journal of Practical Medicine
关键词
局部晚期胃癌
术前放化疗
术后放化疗
顺铂
locally advanced gastric cancer
preoperative chemoradiation
postoperative radiation and chemotherapy
cisplatin
