CAJ | 학술논문

目的：观察同步放化疗对局部晚期胃癌患者的近期疗效，患者生活质量的影响及并发症分析。方法：将55例不能手术的局部晚期胃癌患者随机分为2组，28例进行同步放化疗治疗，先行 XELOX 方案化疗1周期，于2周期化疗第2天同时进行适形放疗，并按化疗周期进行3、4周期 XELOX 方案治疗。27例患者进行4周期 XELOX 方案化疗。结果：无进展生存期（PFS）同步放化疗组为7．1个月，化疗组为5．1个月（P ＜0．05）；肿瘤客观缓解率（ORR）同步放化疗组67．8％，化疗组40．7％（P ＜0．05）；1年生存率同步放化疗组60％高于化疗组51％，两者比较无统计学意义（P ＞0．05）；QLQ －C30评定：治疗后同步放化疗组 PA（疼痛症状）评分、SL（失眠症状）评分低于单纯化疗组（28．5±20．1 vs 40．3±21．0；35．4±19．6 vs 44．5±18．9），P＜0．05，PF（躯体功能）评分高于化疗组（64．2±19．4 vs 60．3±20．4），P ＜0．05。同步放化疗组患者 AP（食欲减退）、NV（恶心呕吐）与 FA（乏力）评分高于单纯化疗组（51．5±20．6 vs 48．3±20．7；46．2±18．7 vs 40．1±13．6；63．0±23．7 vs 60．03±22．6），但 P ＞0．05，而 RF （角色功能）、EF（情绪功能）、CF（认知功能）、SF（社会功能）、QL（总体健康状况）相当，无统计学意义。治疗组Ⅲ／Ⅳ级消化道毒性及Ⅲ／Ⅳ级血液毒性发生率高于对照组（28．6％ vs 18．5％；25．0％ vs 18．5％），但 P 值比较无差异。结论：同步放化疗对局部晚期胃癌患者近期疗效优于化疗组；与单纯化疗比较，同步放化疗患者疼痛、失眠、躯体症状改善、总体生活质量状况相当。患者可耐受同步放化疗消化道毒性及血液毒性。
목적：관찰동보방화료대국부만기위암환자적근기료효，환자생활질량적영향급병발증분석。방법：장55례불능수술적국부만기위암환자수궤분위2조，28례진행동보방화료치료，선행 XELOX 방안화료1주기，우2주기화료제2천동시진행괄형방료，병안화료주기진행3、4주기 XELOX 방안치료。27례환자진행4주기 XELOX 방안화료。결과：무진전생존기（PFS）동보방화료조위7．1개월，화료조위5．1개월（P ＜0．05）；종류객관완해솔（ORR）동보방화료조67．8％，화료조40．7％（P ＜0．05）；1년생존솔동보방화료조60％고우화료조51％，량자비교무통계학의의（P ＞0．05）；QLQ －C30평정：치료후동보방화료조 PA（동통증상）평분、SL（실면증상）평분저우단순화료조（28．5±20．1 vs 40．3±21．0；35．4±19．6 vs 44．5±18．9），P＜0．05，PF（구체공능）평분고우화료조（64．2±19．4 vs 60．3±20．4），P ＜0．05。동보방화료조환자 AP（식욕감퇴）、NV（악심구토）여 FA（핍력）평분고우단순화료조（51．5±20．6 vs 48．3±20．7；46．2±18．7 vs 40．1±13．6；63．0±23．7 vs 60．03±22．6），단 P ＞0．05，이 RF （각색공능）、EF（정서공능）、CF（인지공능）、SF（사회공능）、QL（총체건강상황）상당，무통계학의의。치료조Ⅲ／Ⅳ급소화도독성급Ⅲ／Ⅳ급혈액독성발생솔고우대조조（28．6％ vs 18．5％；25．0％ vs 18．5％），단 P 치비교무차이。결론：동보방화료대국부만기위암환자근기료효우우화료조；여단순화료비교，동보방화료환자동통、실면、구체증상개선、총체생활질량상황상당。환자가내수동보방화료소화도독성급혈액독성。
Objective:To investigate the influence of chemoradiotherapy on patients quality of life and complica-tions of locally advanced gastric carcinoma patients (Ⅱ -Ⅲc ).Methods:All 55 cases of locally advanced gastric cancer patients who can not accepted operation were randomly divided into two groups.After treated with XELOX scheme 1 cycle of chemotherapy,28 patients were accepted 3 -dimensional conformal radiation therapy.In the second day of the next cycle of chemotherapy and chemotherapy cycle XELOX regimen for 3,4 cycle.27 patients received XELOX scheme chemotherapy for 4 cycle.Results:The progress free survival (PFS)of chemoradiotherapy group was 7.1 months while the chemotherapy group was 5.1 months(P <0.05).The objective response rates of tumor (ORR) were 67.8% and 40.7%,respeccivelly(P <0.05);The 1 year survival rate was 60% in the concurrent chemoradio-therapy group and 51% in the chemotherapy group.QLQ C30 evaluation:the score of PA and SL was lower to the chemotherapy(28.5 ±20.1 vs 40.3 ±21.0;35.4 ±19.6 vs 44.5 ±18.9),the PF score was higher than chemothera-py(64.2 ±19.4 vs 60.3 ±20.4),P <0 .05 .AP,NV and FA symptom scores of the chemoradiotherapy were higher than the pure chemotherapy group (51.5 ±20.6 vs 48.3 ±20.7;46.2 ±18.7 vs 40.1 ±13.6;63.0 ±23.7 vs 60.03 ±22.6),but P >0.05,the PF,RF,EF,CF,SF were almost the same.P >0.05.The Ⅲ/Ⅳ incidence of hematological and gastrointestinal of the chemoradiotherapy were higher than the chemotherapy(25.0% vs 18.5%;28.6% vs 18.5%),but P >0.05.Conclusion:The chemoradiotherapy can improve the efficacy of locally advanced gastric carcinoma patients (Ⅱ -Ⅲc )without operation.Compared with simple chemotherapy,chemoradiotherapy could improve the symptoms of pain,sleep and physical function.The gastrointestinal and hematological toxicity could be tolerated.