奥沙利铂、亚叶酸钙联合5-FU的新辅助化疗方案在进展期胃癌治疗中的疗效及安全性

摘要

Objective To investigate the efficacy and safety of oxaliplatin ,leucovorin combined with 5-FU in neoadju-vant chemotherapy for advanced gastric cancer.Methods 60 patients with advanced gastric cancer were randomly divided into the observation group and the control group ,each with 30 cases.The observation group received surgery after neoadjuvant chemo-therapy(oxaliplatin +leucovorin +5-FU).The control group received conventional surgery.Short-term efficacy and postopera-tive efficacy of the 2 groups were compared.Results Complete remission rates in the observation group and the control group were 6.67%and 0%;Partial remission rates in the observation group and the control group were 53.33% and 20.00%;Stable disease rates in the observation group and the control group were 33.33%and 50.00%;The disease progression rates in the ob-servation group and the control group were 6.67% and 30.00%;the short-term effective rates in the observation group and the control group were 60.00%and 20.00%,there was significant difference μ=4.6252,P<0.0001).Tumor resection rates in the observation group and the control group were 96.67% and 80.00%;tumor radical resection rate in the observation group was higher than that of the control group ,there was significant difference (χ2 =5.5543,P=0.0184).The main adverse reactions of the observation group were platelets , gastrointestinal reactions , hemoglobin , white blood cells , and peripheral nerves abnormal , which were mainly in 1,2 level,no 4 level occurred,adverse reactions were tolerable and relieved after treatment.Conclusion Oxaliplatin ,leucovorin combined with 5-FU in neoadjuvant chemotherapy for advanced gastric cancer is effective with less adverse reactions.It is worthy of promotion in clinic.%目的 探讨奥沙利铂、亚叶酸钙联合5-FU的新辅助化疗方案在进展期胃癌治疗中的疗效及安全性. 方法 将60例进展期胃癌患者随机分为观察组和对照组. 观察组30例患者,采用奥沙利铂+亚叶酸钙+5-FU的新辅助化疗之后进行手术. 对照组30例患者,采用常规的手术治疗. 比较2组患者的近期疗效和术后疗效. 结果 观察组的完全缓解率与对照组的完全缓解率分别为6.67%和0%;部分缓解率分别为53.33%和20.00%;疾病稳定率分别为33.33%和50.00%;疾病进展率分别为6.67%和30.00%;观察组与对照组近期疗效的有效率为60.00%和20.00%,差异有统计学意义(μ=4.6252,P<0.0001). 观察组与对照组的肿瘤切除率为96.67%和80.00%;观察组的肿瘤根治性切除率明显高于对照组(χ2 =5.5543,P=0.0184). 观察组患者的主要不良反应为血小板、胃肠反应、血红蛋白、白细胞、外周神经感觉的异常,以1、2级情况为主,无4级情况发生,患者均能承受,对症治疗后缓解. 结论 奥沙利铂、亚叶酸钙联合5-FU的新辅助化疗方案在进展期胃癌治疗中效果良好,毒副作用小,值得临床推广.