CAJ | 학술논문

目的探讨短程新辅助化疗应用于进展期胃癌的可行性,并比较不同化疗方式短程新辅助化疗的临床疗效.方法回顾性分析2008年1月至201 1年12月间在南京中医药大学附属医院接受短程(1个周期)EOF方案(表柔比星、奥沙利铂、氟尿嘧啶加亚叶酸钙)新辅助化疗的310例进展期胃癌患者的临床资料.比较全身静脉化疗方案与区域动脉灌注化疗方案的临床疗效.结果 310例患者均完成了1个周期的短程EOF方案新辅助化疗,无一例因化疗毒副反应而终止.术后病理缓解率为33.9％(105/310),其中5例(1.6％)获病理完全缓解.接受区域动脉灌注化疗者的病理缓解率为42.4％(72/170),明显高于全身静脉化疗者的23.6％ (33/140) (P=0.001).Logistic多因素回归分析证实,化疗方式是影响进展期胃癌短程新辅助化疗后病理缓解率的独立危险因素(HR=1.827; 95％ CI:1.006～3.316; P=0.048).结论进展期胃癌短程新辅助化疗病理缓解率总体较低;区域动脉灌注化疗能提高进展期胃癌短程新辅助化疗的术后病理缓解率.
목적 탐토단정신보조화료응용우진전기위암적가행성,병비교불동화료방식단정신보조화료적림상료효.방법 회고성분석2008년1월지201 1년12월간재남경중의약대학부속의원접수단정(1개주기)EOF방안(표유비성、오사리박、불뇨밀정가아협산개)신보조화료적310례진전기위암환자적림상자료.비교전신정맥화료방안여구역동맥관주화료방안적림상료효.결과 310례환자균완성료1개주기적단정EOF방안신보조화료,무일례인화료독부반응이종지.술후병리완해솔위33.9％(105/310),기중5례(1.6％)획병리완전완해.접수구역동맥관주화료자적병리완해솔위42.4％(72/170),명현고우전신정맥화료자적23.6％ (33/140) (P=0.001).Logistic다인소회귀분석증실,화료방식시영향진전기위암단정신보조화료후병리완해솔적독립위험인소(HR=1.827; 95％ CI:1.006～3.316; P=0.048).결론 진전기위암단정신보조화료병리완해솔총체교저;구역동맥관주화료능제고진전기위암단정신보조화료적술후병리완해솔.
Objective To explore the feasibility of short-term neoadjuvant chemotherapy (NACT) in patients with advanced gastric cancer (AGC),and to compare clinical efficacy of short-term neoadjuvant chemotherapy with different ways.Methods Clinical data of 310 AGC patients treated with one course of NACT using EOF regimen (epirubicin,oxaliplatin and fluorouracil plus calcium folinate) in our hospital from January 2008 to December 2011 were retrospectively analyzes.Efficacy was compared between regional arterial infusion chemotherapy and intravenously chemotherapy.Results All the 310 AGC patients completed one course of NACT and none was interrupted by adverse events.Postoperative pathological remission rate was 33.9％ (105/310) and 5 patients (1.6％) had complete pathological remission.The pathologic response rate in the regional arterial infusion chemotherapy group was higher than that in the intravenously chemotherapy group (42.4％ vs.23.6％,P=0.001).Multivariate analysis revealed that chemotherapy method (HR=1.827,95％CI:1.006-3.316,P=0.048) was associated with significantly higher pathologic response.Conclusions Pathological response rate is quite low following short-term NACT.Regional arterial infusion chemotherapy with short-term NACT can improve the pathological response rate of advanced gastric cancer.