首页> 中文期刊> 《实用医院临床杂志》 >弥漫浸润型胃癌患者术前多西紫杉醇+顺铂+氟尿嘧啶方案化疗的疗效及安全性观察

弥漫浸润型胃癌患者术前多西紫杉醇+顺铂+氟尿嘧啶方案化疗的疗效及安全性观察

         

摘要

Objective To investigate the therapeutic effect of DCF regimen as pre-operative chemotherapy in the treatment of Borrmann's type Ⅳ gastric cancer.Methods Forty-four patients with advanced Borrmann 's type Ⅳ gastric cancer were divided into chemotherapy +operation group and conventional operation group before operation .The chemotherapy +operation group were treated with DCF chemotherapy regimen for 2 cycles.The chemotherapeutic adverse reactions ,CT remission degree and pathological response degree were observed .The relationship between the CT remission degree and pathological response degree were analyzed .The R0 resec-tion rate and the survival rate were compared between the two groups .Results The major adverse reactions in the chemotherapy +op-eration group were nausea and vomiting after chemotherapy .There were no IV grade adverse reactions .The total effective rate of CT re-mission was 68.1%.The tumor control rate was 90.9%.The tumor down-staging rate was 27.3%.The effective rate of the pathologic grades was 18.18%(4/22).There was no correlation between CT remission and pathological response (r =-0.42,P =0.051).The R0 resection rate in the per-operative chemotherapy group was significantly higher than that in the surgery alone group ( P <0.05 ) . There was no statistically significant difference in overall survival between the two groups .Conclusion The per-operative chemotherapy by the DCF regimen for per-operative chemotherapy in advanced Borrmann 's type Ⅳgastric cancer is safe that can improve the R 0 re-section rate.%目的:探讨多西紫杉醇+顺铂+氟尿嘧啶( DCF)方案应用于弥漫浸润型( BorrmannⅣ)胃癌患者术前化疗的疗效与安全性。方法44例进展期Borrmann IV型胃癌患者,术前分为化疗+手术组和常规手术组,化疗+手术组患者术前行DCF方案化疗2周期。观察化疗+手术组的化疗毒副反应、CT缓解程度、病理反应程度。评价CT缓解程度与病理反应程度之间的关系。比较两组间R0切除率及生存期的差异。结果化疗+手术组化疗后的毒副反应以恶心、呕吐为主,未出现IV级不良反应。 CT缓解程度中总有效率为68.1%,肿瘤控制率为90.9%,降期率27.3%。病理反应分级中有效4例,占18.18%(4/22)。 CT缓解程度与病理反应程度无相关性( r s=-0.42,P =0.051)。化疗+手术组的R0切除率明显高于常规手术组,差异有统计学意义( P<0.05)。两组生存期比较差异无统计学意义( P >0.05)。结论 DCF方案应用于Borrmann IV型胃癌术前化疗是安全的,可提高Borrmann IV型胃癌的R0切除率。

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