CAJ | 학술논문

目的评价胃癌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45例胃癌术后放疗患者,其中38例为同期放化疗,男31例,女14例,中位年龄54岁,IB～IV(M0)期.采用三维适形或调强放疗技术,靶区包括瘤床和区域淋巴引流区,放疗剂量45～55 Gy分25～30次.化疗药物为氟尿嘧啶(21例)或希罗达(17例).毒性分级标准采用CTCAE3.0.结果仅2例因无法耐受治疗而中止放疗,其中1例为术后肠粘连,1例为3级胃肠道反应.其余毒性表现为1+2、3级白细胞减少发生率分别为71%、7%;1+2、3级胃肠道反应发生率分别为56%、16%;1+2级乏力、食欲不振发生率为38%.1年总生存率、无复发生存率和局部控制率分别为87%、82%、95%.结论局部进展期胃癌患者可耐受术后放化疗毒性,术后放化疗可提高局部控制率,是否可提高总生存率尚需更长时间随访和更多前瞻陛随机试验证实.
목적 평개위암환자접수술후동기방화료적독성화근기료효.방법 회고분석45례위암술후방료환자,기중38례위동기방화료,남31례,녀14례,중위년령54세,IB～IV(M0)기.채용삼유괄형혹조강방료기술,파구포괄류상화구역림파인류구,방료제량45～55 Gy분25～30차.화료약물위불뇨밀정(21례)혹희라체(17례).독성분급표준채용CTCAE3.0.결과 부2례인무법내수치료이중지방료,기중1례위술후장점련,1례위3급위장도반응.기여독성표현위1+2、3급백세포감소발생솔분별위71%、7%;1+2、3급위장도반응발생솔분별위56%、16%;1+2급핍력、식욕불진발생솔위38%.1년총생존솔、무복발생존솔화국부공제솔분별위87%、82%、95%.결론 국부진전기위암환자가내수술후방화료독성,술후방화료가제고국부공제솔,시부가제고총생존솔상수경장시간수방화경다전첨폐수궤시험증실.
Objective To evaluate the toxicity and efficacy of post-operative chemoradiotherapy for gastric cancer. Methods Forty-five gastric cancer patients treated with post-operative radiation ± concurrent chemotherapy were retrospectively analyzed. Among them, 14 were female and 31 were male. The median age was 54 (30-72) years. Pathology stages were IB-IV. Radiotherapy of doses from 45 Gy/25fx to 55 Gy/30fx was delivered to the tumor bed and regional lymph nodes with 3D conformal or IMRT technology.Concurrent chemotherapy agent was fluorouracil or capacitabine. Results All patients except 2 (4%)completed radiotherapy as planned. The most common acute toxicities were hematologic and gastrointestinal effects. The incidence of the patients was 56% with mild nausea/vomiting,71% and 7% with grade Ⅰ / Ⅱ and Ⅲ leucopenia, and 38% with grade Ⅰ/Ⅱ hypodynamia and anepithymia. The 1-year overall survival,relapse-free survival and local control rates were 87% ,82% and 95%, respectively. Conclusions Postoperative chemoradiation for patients with locally advanced gastric cancer is tolerable. Our study shows the advantage of post-operative chemoradiation for local control. However,further prospective randomized trial is needed to validate the efficacy.