不同辅助化疗方案联合手术治疗进展期胃癌的疗效比较

Comparison in efficacy of neoadjuvant chemotherapies combined with surgery for advanced gastric cancer

  • 摘要:
      目的  比较不同辅助化疗方案联合手术治疗进展期胃癌的疗效及安全性。
      方法  将74例进展期胃癌患者随机分为2组,每组37例。对照组术前化疗方案为卡培他滨联合奥沙利铂(XELOX),观察组术前化疗方案为替吉奥联合奥沙利铂(SOX)新辅助化疗,化疗后根据患者病情实施手术治疗,比较2组患者的疗效、肿瘤标志物水平、术后生存率和不良反应发生情况。
      结果  治疗后,观察组总缓解率高于对照组,肿瘤标志物糖类抗原724(CA724)、糖类抗原242(CA242)、糖类抗原199(CA199)、癌胚抗原(CEA)水平均低于对照组,差异有统计学意义(P < 0.05)。观察组术后12个月的生存率高于对照组,手足皮肤反应、肝功能损伤的发生率低于对照组,差异有统计学意义(P < 0.05)。
      结论  采用SOX新辅助化疗方案联合手术治疗进展期胃癌安全可靠,可提高患者术后生存率,且不良反应发生率低于XELOX方案。

     

    Abstract:
      Objective  To evaluate the efficacy and safety of neoadjuvant chemotherapies combined with surgery in the treatment of advanced gastric cancer.
      Methods  A total of 74 patients with advanced gastric cancer were randomly divided into two groups, with 37 cases in each group. The control group received preoperative chemotherapy by capecitabine and oxaliplatin (XELOX), while the observation group received S-1 and oxaliplatin (SOX) as neoadjuvant chemotherapy. One week after chemotherapy, patients received surgical treatment according to their conditions. The efficacy and safety of different methods were compared.
      Results  After treatment, the total remission rate of the observation group was significantly higher, and tumor markers such as carbohydrate antigen 724 (CA724), carbohydrate antigen 242 (CA242), carbohydrate antigen 199 (CA199) and carcinoembryonic antigen (CEA) levels were significantly lower than those in the control group(P < 0.05). The 12-month survival rate was significantly higher, and the incidence rates of adverse reactions of hand-foot skin reaction and liver function injury were significantly lower than those of the control group(P < 0.05).
      Conclusion  SOX neoadjuvant chemotherapy combined with surgery for advanced gastric cancer can improve the survival rate of patients, and has lower incidence rate of adverse reactions than XELOX therapy.

     

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