改良FOLFOX6新辅助化疗与术后化疗治疗进展期胃癌的临床效果比较

摘要

目的：比较改良FOLFOX6新辅助化疗与术后化疗治疗进展期胃癌的临床效果及不良反应。方法选择2009年3月~2010年6月瑞安市人民医院60例经组织学证实的局部进展期或转移性胃癌患者，分为改良FOL-FOX6新辅助化疗组(术前组)、改良FOLFOX6术后辅助化疗组(术后组)，化疗4周后进行疗效评价，观察两组临床效果、疾病进展时间、生存时间和不良反应。结果术前组总有效率及肿瘤控制率(50.0%、76.7%)均高于术后组(43.3%、70.0%)，差异有统计学意义(χ2=5.90，5.88，均P<0.05)。术前组Ⅲ~Ⅳ度不良反应发生为8例，术后组Ⅲ~Ⅳ度不良反应发生为13例，差异有统计学意义(χ2=10.76，P<0.05)。术前组肿瘤进展时间少于术后组[(10.4±2.4)个月比(16.9±1.7)个月]，2年生存率高于术后组(86.67%比66.67%)，差异有统计学意义(t =7.71，χ2=8.02，均P<0.05)。结论改良FOLFOX6新辅助化疗相对于改良FOLFOX6术后辅助化疗而言，其疗效和肿瘤进展时间、生存时间比较更佳，预期将为临床进展期胃癌的治疗提供新的高效安全的化疗方案，能有效提高进展期胃癌患者生存时间和生活质量，减少患者经济负担。%Objective To observe the clinical effect and adverse reaction of modified FOLFOX6 neoadjuvant chemother-apy and postoperative chemotherapy in advanced gastric cancer. Methods 60 patients with histologically proven locally advanced or metastatic gastric cancerin March 2009 to June 2010 in the People's Hospital of Rui'an City were random-ly divided into modified FOLFOX6 neoadjuvant chemotherapy group (preoperation group), chemotherapy group modified FOLFOX6 operation (postoperation group), the therapeutic effect was evaluated after 4 weeks, the clinical curative ef-fect, disease progression and survival time, adverse reaction were observed. Results The total effectiveness and tumor control rate of preoperation group were 50.0%, 76.7%, which were higher than those of postoperation group (43.3%, 70.0%), with statistical significance between the two groups (χ2=5.90, 5.88, all P<0.05). The preoperation group forⅢ-Ⅳ degree of adverse reactions were 8 cases, and the postoperation group were 13 cases, there was significant differ-ence (χ2= 10.76, P< 0.05). The tumor progression time was shorter in preoperation group than that in postoperation group [(10.4±2.4) months v s (16.9±1.7) months], and survival rate in 2 years was higher in preoperation group than that in postoperation group (86.67%v s 66.67%), there were significant differences between two groups (t =7.71,χ2=8.02, all P<0.05). Conclusion The curative effect and tumor progression,time survival time in modified FOLFOX6 neoadju-vant chemotherapy is better than the improved FOLFOX6 postoperative adjuvant, That is expected to provide efficient and safe new chemotherapy for the treatment of advanced gastric cancer, and can effectively improve survival time and quality of life and reduce the economic burden of the patients with advanced gastric cancer.