目的:探讨评估术前XELOX(卡培他滨联合奥沙利铂)新辅助化疗方案对进展期胃癌患者临床疗效的影响.方法:连续性纳入自2014年3月至2015年3月我院所收治的进展期胃癌患者132例,随机分为研究组和对照组.研究组术前给予2疗程XELOX新辅助化疗后行手术治疗,对照组给予手术治疗.比较两组患者根治性手术比例、手术情况、术后血清肿瘤标志物变化等近期预后差异,且所有患者随访2年,比较两组患者远期预后差异.结果:研究组2疗程XELOX术前化疗后客观有效率为39.39％,疾病控制率为90.91％,化疗后肿瘤临床分期较化疗前显著下降(P=0.003).研究组完成胃癌根治术患者手术比例明显高于对照组(P=0.017),且研究组手术时间更短(P=0.000),术中出血量(P=0.002)以及术后引流量(P=0.000)更少.术后研究组血清肿瘤标志物癌胚抗原(CEA)、糖类蛋白19－9(CA19－9)、糖类抗原125(CA125)以及组织多肽特异性抗原(TPS)水平均显著性低于对照组,差异具有统计学意义(P＜0.05).在远期预后方面,2年随访期间研究组无病生存时间以及平均生存时间明显优于对照组,差异具有统计学意义(P＜0.05),且研究组复发率明显更低(P=0.005),但两组死亡率未见统计学差异(P=0.083).结论:进展期胃癌患者术前接受XE-LOX化疗可以有效提高根治性手术比例,降低手术风险和术后肿瘤活性,从而改善患者远期预后.%Objective:To evaluate the effect of preoperative XELOX(capecitabine+oxaliplatin)neoadjuvant chemotherapy regimen on the clinical efficacy of advanced gastric cancer patients.Methods:132 patients with ad-vanced gastric cancer were collected from March 2014 to March 2015,and were randomly divided into the study group and the control group.The study group was given 2 courses of XELOX chemotherapy before surgery,and the control group was treated with surgery directly.Recent prognosis index such as proportion of radical surgery,surgery situation,postoperative changes of serum tumor markers were compared between two groups,and all patients were followed up for 2 years.Long－term prognosis was also compared between two groups.Results:After 2 courses of XELOX chemo-therapy,the objective rate was 39.39％and the disease control rate was 90.91％,and tumor clinical stage was signifi-cantly decreased after chemotherapy(P=0.003)in study group.Proportion of radical surgery in the study group was notably higher than that of control group(P=0.017),and with shorter operation time(P=0.000),lesser intraoper-ative blood loss(P=0.002)and lesser postopreation drainage(P=0.000).The levels of postoperative serum tumor markers including carcinoembryonic antigen(CEA)and carbohydrate protein 19－9(CA19－9),carbohydrate anti-gen 125(CA125),as well as the level of tissue polypeptide specific antigen(TPS)were significantly lower in the study group than the control group,and the difference was statistically significant(P＜0.05).In terms of long－term prognosis,after 2 years follow－up period,disease－free survival time and the average survival time were better in the study group than that in the control group,and difference had statistical significance(P＜0.05),and the study group showed significantly lower recurrence rate(P=0.005),but mortality did not show the statistically significant differ-ence(P=0.083).Conclusion:Preoperative XELOX chemotherapy can effectively improve the ratio of radical sur-gery,reduce the risk of operation and postoperative tumor activity,and improve the long－term prognosis of patients with advanced gastric cancer.
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