CAJ | 학술논문

目的比较局部进展期胃癌根治术后同期放化疗(RCT)与单纯化疗(CT)的疗效和不良反应.方法 83例患者随机分为RCT组(43例)和CT组(40例).RCT组采用三维适形放疗 45Gy同期口服卡培他滨化疗(1600 mg/m2),放疗结束2周后继续用FOLFOx4方案巩固化疗4～6周期.CT组采用FOLFOX4方案化疗6～8周期.Kaplan-Meier法计算生存率等并Logrank检验.结果随访率为96％,RCT和CT组随访时间满2、3年者分别为37、12例和31、10例.RCT组和CT组1、2、3年局部控制率分别为100％、97％、94％和95％、87％、73％(x2=4.54,P=0.033),生存率分别为98％、86％、81％和93％、80％、64％(x2=3.96,P =0.047).RCT组和CT组治疗期间≥3级白细胞下降发生率分别为23％和15％(x2=0.93,P=0.630),≥3级胃肠道反应发生率分别为16％和10％(x2=0.95,P=0.624).结论局部进展期胃癌根治术后RCT比CT可提高患者局部控制率和生存率,不良反应可耐受.
목적 비교국부진전기위암근치술후동기방화료(RCT)여단순화료(CT)적료효화불량반응.방법 83례환자수궤분위RCT조(43례)화CT조(40례).RCT조채용삼유괄형방 료 45Gy동기구복잡배타빈화료(1600 mg/m2),방료결속2주후계속용FOLFOx4방안공고화료4～6주기.CT조채용FOLFOX4방안화료6～8주기.Kaplan-Meier법계산생존솔등병Logrank검험.결과 수방솔위96％,RCT화CT조수방시간만2、3년자분별위37、12례화31、10례.RCT조화CT조1、2、3년국부공제솔분별위100％、97％、94％화95％、87％、73％(x2=4.54,P=0.033),생존솔분별위98％、86％、81％화93％、80％、64％(x2=3.96,P =0.047).RCT조화CT조치료기간≥3급백세포하강발생솔분별위23％화15％(x2=0.93,P=0.630),≥3급위장도반응발생솔분별위16％화10％(x2=0.95,P=0.624).결론 국부진전기위암근치술후RCT비CT가제고환자국부공제솔화생존솔,불량반응가내수.
Objective To investigate the efficacy and toxicity of postoperative radiochemotherapy compared with chemotherapy alone in the treatment of locally advanced gastric cancer.Methods A total of 83 patients with resected adenocarcinoma of the stomach were randomly assigned to postoperative radiochemotherapy group (RCT) ( n =43 ) or chemotherapy alone group (CT) ( n =40 ).Patients in RCT group received radiotherapy concurrent with capecitabine chemotherapy then followed by 4 - 6 cycles of FOLFOX4 chemotherapy.The total dose of radiation was 45 Gy.The dose of capecitabine was 1600 mg/m2per day.In the CT group,patients received 6 - 8 cycles FOLFOX4 chemotherapy.Survival was analyzed using Kaplan-Meier method and Logrank test. Results The follow-up rate was 96％. The number of patients who had a minimum of 2-,3-year follow-up time were 37,12 in the RCT group and 31,10 in the CT group.The 1-,2-,3-year local control rates for RCT and CT groups were 100％,97％,94％ and 95％,87％,73％ (x2 =4.54,P =0.033),respectively.The 1-,2-,3-year survival rates were 98％,86％,81％ in the RCT group,with 93％,80％,64％ in the CT group ( x2 =3.96,P =0.047 ).The incidence of grade 3hematological toxicity in the RCT and CT group was 23％ vs 15％ ( x2 =0.93,P =0.630 ),and grade 3gastrointestinal toxicity was 16％ vs 10％ ( x2 =0.95,P =0.624 ). Conclusions Compared with chemotherapy alone,postoperative radiochemotherapy can improve survival of locally advanced gastric cancer patients with acceptable toxicities.