目的 评价进展期胃癌术后患者接受术后同期放化疗的毒性和近期疗效.方法 回顾分析48例胃癌术后放化疗患者,其中均为同期放化疗,采用三维适形放疗技术,靶区包括瘤床和区域淋巴引流区,放疗剂量45～50 cGy分25～28次.化疗药物为卡培他滨,初始剂量1 000 mg/m2,2次/d,周一至周五,毒性分级标准采用CTCAE3.0.结果 1+2、3级白细胞减少发生率分别为68.8%、8.3%;1+2、3级胃肠道反应发生率分别为50.0%、14.6%.1年总生存率、无复发生存率和局部控制率分别为87.5%、83.3%、95.8%.结论 术后放化疗是治疗进展期胃癌较为安全有效的综合治疗手段之一,患者可耐受术后放化疗毒性,可提高局部控制率.%Objective To evaluate the toxicity and efficacy of post - operative radiotherapy plus capecitabine in treatment of patients with advanced gastric cancer after operation. Methods The clinical data of 48 patients with gastric cancer treated by post - operative radiotherapy and capecitabine were retrospectively analyzed. Radiotherapy with dosage from 45 Gy/25 fx to 50 Gy/28 fx was delivered to tumor bed and regional lymph nodes with 3D conformal technique. The applied agent of chemotherapy was capecitabine, and it was administered at dosage of 1 000 mg/ m2 , twice per day. Capecitabine was orally taken from Monday to Friday. Results The rates of Ⅰ/Ⅱ and Ⅲ grades of leucopenia were 68. 8% and 8. 3% respectively. The rates of Ⅰ/Ⅱ and Ⅲ grades of gastrointestinal reactions were 50. 0% and 14. 6% respectively. The 1 - year overall survival, relapse -free survival and local control rates were 87. 5% , 83. 3% and 95. 8% , respectively. Conclusion Post - operative radiotherapy combined with administration of capecitabine in treatment of patients with advanced gastric cancer is a safe and effective comprehensive therapeutic measure. Its toxic reactions can be tolerable by patients. This study shows the advantages of post - operative radiotherapy combined with capecitabine can raise the successful rate of local control in patients with advanced gastric cancer after operation.
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