目的 探讨FOLFOX7方案对进展期胃癌新辅助化疗的有效性和安全性。方法 将66例进展期胃癌患者随机分为治疗组（新辅助化疗+手术组）33例，对照组（单纯手术组）33例。治疗组术前进行新辅助化疗(FOLFOX7方案) 2个周期。观察两组手术后肿瘤原发病灶的缓解情况、手术切除率、组织学疗效、手术并发症发生率及化疗的不良反应。结果 新辅助化疗组的手术切除率达93.9%，获得根治性切除率达57.6％，均明显高于对照组（78.8％，36.4％），差异均有统计学意义(χ2=4.234,P=0.0394；χ2=3.911，P=0.048)。两组并发症发生率差异无统计学意义（P＞0.05）。结论 进展期胃癌应用FOLFOX7方案新辅助化疗疗效显著，耐受性良好。
Abstract
Objective To evaluate the efficacy and toxicity of neoadjuvant chemotherapy with FOLFOX7 in the treatment of advanced gastric cancer. Methods Sixty-six patients with advanced gastric cancer were enrolled and were randomized to groups treated with or without neoadjuvant chemotherapy before operation (n=33/group). Preoperative chemotherapy with two cycles of FOLFOX7 were administered. The response in the primary tumor, resection rate and the chemotherapy toxicity were observed after neoadjuvant chemotherapy with FOLFOX7. Results The overall resection rate and radical resection rate in the operation with neoadjuvant chemotherapy group (93.9% and 57.6％) were higher than those in the operation without neoadjuvant chemotherapy group (78.8％and 36.4％). There were significant differences in the overall resection rate and radical resection rate between the two groups (χ2=3.911，P=0.048 and χ2=4.234，P=0.0394 ), while no significant change in complication incidence rate between the two groups. Histopathogical responses were evaluated as mild，moderate and marked in 3，4 and l cases, respectively．Conclusions FOLFOX7 is an effective and well-tolerated medicament as neoadjvant chemotherapy for the patients with advanced gastric cancer.
关键词
进展期胃癌 /
新辅助化疗 /
外科手术
Key words
advanced gastric cancer /
neoadjuvant chemotherapy /
surgery
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参考文献
［1］ Mezhir J J, Tang L H, Coit D G. Neoadjuvant therapy of locally advanced gastric cancer ［J］. Surg Oncol, 2010，101(4):305-314.
［2］ 杨 喆，王治国.多西他赛联合顺铂、氟尿嘧啶和亚叶酸的新辅助化疗方案治疗不能切除进展期胃癌的疗效观察［J］.中国癌症杂志，2006，16（5）：346-350.
［3］ Trotti A, Bentzen S M. The need for adverse effects reporting standards in oncology clinical trials［J］. J Clin Oncol , 2004, 22(1):19-22.
［4］ 盛贤能，韩晓鹏，李文惠，等.进展期胃癌新辅助化疗的现状与进展［J］.中国综合临床,2010，26（4）：444-446.
［5］ Frei E. Clinical cancer research: an embattled species［J］. Cancer,1982, 50: 1979-1992.
［6］ Wilke H, Prensser P, Fink U, et al．Preoperative chemotherapy in locally advanced and nonresectable gastric cancer：a phase II study with etoposide，doxorubicin，and cisplatin［J］．J Clin Oncol, 1989, 7(9)：1318-1326．
［7］ Cunningham D, Allum W H, Stenning S P,et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cance［J］.N Engl J Med, 2006, 355(1):11-20.
［8］ Ng K, Meyerhardt J A, Fuchs C S. Adjuvant and neoadjuvant approaches in gastric cancer［J］.Cancer J, 2007,13(3):168-174.
［9］ Sym S J, Chang H M, Ryu M H, et al. Neoadjuvant docetaxel, capecitabine and cisplatin (DXP) in patients with unresectable locally advanced or metastatic gastric cancer［J］. Ann Surg Oncol,2010,17(4):1024-1032.
［10］ Becker K，Mueller J D，Schulmacher C，et a1．Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy［J］．Cancer，2003，98(7)：1521-1530.
［11］ Lasser P, Rougier P, Mahjoubi M, et al. Neoadjuvant chemotherapy in locally advanced gastric adenocarcinoma［J］. Chirurgie, 1989, 115: 365-372.
［12］ Kato M, Kinoshita K, Sawa T, et al. Neoadjuvant chemotherapy of far advanced gastric cancer--effect of preoperative chemotherapy by PMUE (CDDP, MMC, UFT,etoposide) ［J］. Gan To Kagaku Ryoho,1990,17: 391-396.
［13］ Chung H C, Roh J K, Park Y J, et al. Locally advanced unresectable gastric cancer successfully resected after neoadjuvant chemotherapy with FADE regimen［J］.Yonsei Med J ,1990, 31: 74-79.
［14］ 金懋林.进展期胃癌全身化学治疗研究新进展［J］.癌症进展杂志，2007 , 5(1):18-24.
［15］ Kinoshita K，Yonemura Y，Sawa T．5-fluorouracil，methotrexate，leucovorin，CDDP and epirnbicin (FEPMTX)：a wide-spectrum regimen ot salvage chemotherapy for high grade advanced gastric cancer［J］．Hepatogastroenterology，2003，50(53)：1716-1719．[ZK)]
(2012-07-25
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