胃癌新辅助化疗疗效分析及机体组成营养状况变化研究

摘要

Objective To evaluate the clinical effectiveness of neoadjuvant chemotherapy in the treatment of advanced gastric cancer patients retrospectively. Methods Sixty - six patients with advanced gastric cancer received chemotherapy: Oxaliplatin 130 mg/m2 I. V, The first day; combining oral Capecitabine 2 500 mg/m2, from the first day to the fourteenth day; and repeated every 3 weeks. Results 3 cases (4.5%) achieved CR, 33 cases (50.0%) had PR, 24 cases(36. 3%) had SD, 6 cases(9.0%) had PD, with an overall response rate of 54. 5% . The patients had significant increase of body weight, body mass index and lean body mass on average. The difference had statistical significance. Among all patients, 12 cases had weight increase over 10% and 21 over 5%, 15 remained unchanged, and 18 had weight decrease (Six were caused by pyloric obstruc tion). 39 cases underwent D2 radical resection, 18 cases underwent D2 + radical resection and 9 cases underwent palliative gastrectomy, and the radical resection rate was 86. 4 %. Conclusion Neoadjuvant chemotherapy may improve staging and cancer resectability for locally advance gastric cancer.%目的 研究胃癌病人新辅助化疗的疗效、营养状况及机体组成变化.方法 对66例以淋巴结转移为主的进展期胃癌患者采用卡培他滨+奥沙利铂方案化疗,观察化疗疗效、手术情况、机体组成变化和化疗毒副反应情况.结果 66例完全缓解(CR)3例(4.5％),部分缓解(PR)33例(50.0％),稳定(SD)24例(36.3％),进展(PD)6例(9.0％),近期客观有效率(CR+PR)54.5％；平均体重(BM)、体质指数(BMI)与肌肉群(LBM)增加明显,差异有统计学意义,其中体重增加＞10％者12例,体重增加＞5％者21例,体重维持不变者15例,体重下降者18例(其中6例系幽门梗阻引起)；行D2根治手术39例(59.1％),D2+根治手术18例(27.2％),姑息切除手术9例(13.6％),手术根治切除率达86.4％.结论 新辅助化疗可以减轻肿瘤负荷,缩小病灶,降低原发病灶分期,并能改善病人的营养状况,有助于提高进展期胃癌根治术的成功率.