Xelox方案与Sox方案用于胃癌新辅助化疗的临床疗效比较

摘要

目的：比较Xelox方案与Sox方案用于胃癌新辅助化疗的临床疗效，为胃癌患者探寻更多临床受益的治疗方法。方法随机选择兰州大学第一医院肿瘤外科收治的胃癌患者86例，根据其接受的化疗方案分为两组：以Xelox方案作为新辅助化疗的患者40例，以Sox方案作为新辅助化疗的患者46例。进行3周期的新辅助化疗后，观察和比较两组患者的近期疗效、肿瘤分期、胃癌根治性手术切除率，并对其预后进行随访观察。结果40例Xelox方案新辅助化疗的胃癌患者中，RR为12例（30.0％）；进行根治性胃癌切除术25例（62.5％），未切除15例（37.5）；术后Ⅰ期5例（12.5％）、Ⅱ期3例（7.5％）、Ⅲ期12例（30.0％）、Ⅳ期20例（50.0％）；总生存期为6~23个月，中位生存期为18个月，中位肿瘤进展时间为15个月。46例Sox方案新辅助化疗的胃癌患者中，RR为27例（59.0％）；进行根治性胃癌切除术38例（82.6％），未切除8例（17.4％）；术后Ⅰ期17例（37.0％）、Ⅱ期11例（24.0％）、Ⅲ期5例（11.0％）、Ⅳ期13例（28.0％）；生存期为8~24个月，中位生存期为23个月，中位肿瘤进展时间为20个月。结论与Xelox方案相比，Sox方案用于胃癌的新辅助化疗可更加显著地提高近期疗效，改善患者预后，患者临床获益更佳，可优先用于胃癌的治疗。%Objective To compare the efficacy of Xelox and Sox neoadjuvant chemotherapies in the treatment of gastric cancer in order to explore a therapy with better clinical outcomes for patients. Methods A total of 86 gastric cancer cases in the Department of Oncological Surgery in First Hospital of Lanzhou University were randomly selected and divided into two groups according to different chemotherapies. And after being treated with 3 periods of neoadjuvant chemotherapies, the Xelox and Sox groups were observed and compared in terms of recent efficacy, tumor stages and radical gastrectomy rates. Prognosis follow-ups were also carried out for efficacy comparison. Results Among the 40 cases of Xelox neoadjuvant chemotherapy, there were 12 cases (30.0%) of RR, 25 cases (62.5%) of radical gastrectomy and 15 cases (37.5%) of non-radical gastrectomy;5 cases (12.5%) were in postoperative phaseⅠ, 3 cases (7.5%) in phaseⅡ,12 cases (30.0%) in phaseⅢ, and 20 cases (50.0%) in phaseⅣ;the overall survival time for the 40 cases was 6-23 months and median survival time was 18 months;time to tumor progression was from 1 to 23 months, with a median value of 15 months. Among the 46 cases of Sox neoadjuvant chemotherapy, there were 27 cases (59.0%) of RR, 38 cases (82.6%) of radical gastrectomy and 8 cases (17.4%) of non-radical gastrectomy;17 cases (37%) were in postoperative phaseⅠ,11 cases (24%) in phaseⅡ, 5 cases (11.0%) in phaseⅢ, and 13 cases (28.0%) in phaseⅣ;the overall survival time for the 46 cases was 8-24 months and median survival time 23 months;time to tumor progression was from 5 to 24 months, with a median value of 20 months. Conclusions Sox neoadjuvant chemotherapy in the treatment of gastric cancer is significantly better than xelox in terms of short-term effect, prognosis and clinical benefits, thus it is preferable for clinical application.