5-氟尿嘧啶为基础的化疗方案联合三维适形调强放疗用于进展期胃癌术后的临床观察
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篇名: 5-氟尿嘧啶为基础的化疗方案联合三维适形调强放疗用于进展期胃癌术后的临床观察
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摘要: 目的: 观察5-氟尿嘧啶(5-FU)为基础的化疗方案联合三维适形调强放疗用于进展期胃癌术后的疗效和安全性。方法:110例行根治切除的进展期胃癌患者随机分为对照组(55例)和序贯组(55例)。对照组患者给予5-FU注射液400 mg/(m2·d),静脉推注后,再给予600 mg/m2持续泵注22 h,d1~2+注射用盐酸吡柔比星50 mg,静脉滴注,d1+注射用奥沙利铂150 mg,静脉滴注,d1;序贯组患者在对照组治疗的基础上加用三维适形调强放疗,于第4个化疗周期后开始行三维适形调强放疗2周,总剂量DT40~45 Gy/1.8 Gy/24~25F。两组均以3周为1个周期,共治疗6个周期。随访两组患者1、2、3年总生存率及无进展生存率,转移率及Ⅲ~Ⅳ度不良反应发生情况。结果:序贯组患者随访1、2、3年总生存率和随访1、2、3年无进展生存率均显著高于对照组,序贯组患者淋巴结转移率和远处转移率均显著低于对照组,差异均有统计学意义(P<0.05)。两组患者Ⅲ~Ⅳ度恶心呕吐、脱发、骨髓抑制发生率比较,差异均无统计学意义(P>0.05)。结论:5-FU为基础化疗方案联合三维适形调强放疗可延长进展期胃癌术后患者的生存时间,降低远期转移率,且安全性相当。
ABSTRACT: OBJECTIVE: To observe the efficacy and safety of sequential chemotherapy on the basis of 5-FU combined with three-dimensional conformal intensity modulated radiotherapy in the treatment of postoperative advanced gastric cancer. METHODS: 110 patients with advanced gastric cancer were randomly divided into control group (55 cases) and sequential group (55 cases). Control group was given 400 mg/(m2·d) 5-FU injection by intravenous injection, then given 600 mg/m2 for continuous infusion 22 h, d1-2+50 mg/d Pirarubicin hydrochloride for injection, intravenous injection, d1+150 mg/d Oxaliplatin for injection, intravenous injection, d1,three-dimensional conformal intensity modulated radiotherapy was conducted for 2 weeks after the 4th chemotherapy,and the total dosage was DT40-45 Gy/1.8 Gy/24-25F. sequential group was additionally given three-dimensional conformal intensity modulated radiotherapy; 3-week was regarded as a treatment course, and it lasted 6 courses. The total survival rate and progression-free survival rate in 1,2 and 3 years, metastasis rate and incidence of adverse reactions in 2 groups were followed-up. RESULTS: The total survival rate and progression-free survival rate in 1, 2 and 3 years in sequential group were significantly higher than control group, lymphatic metastasis rate and distant metastasis rate in sequential group were significantly lower than control group, the differences were statistically significant (P<0.05). And there were no significant differences in the nausea, vomiting, hair loss and incidence of bone marrow suppression between 2 groups (P>0.05). CONCLUSIONS: Sequential chemotherapy on the basis of 5-FU combined with three-dimensional conformal intensity modulated radiotherapy can effectively prolong the survival time and reduce long-term metastasis rate of patients in the treatment of postoperative advanced gastric cancer, with similar safety.
期刊: 2016年第27卷第15期
作者: 张书俊,王耿泽,刘建文
AUTHORS: ZHANG Shujun,WANG Gengze,LIU Jianwen
关键字: 5-氟尿嘧啶;吡柔比星;奥沙利铂;三维适形调强放疗;化疗;序贯;进展期胃癌
KEYWORDS: 5-FU; Pirarubicin; Oxaliplatin; Three-dimensional conformal in tensity modulated radiotherapy; Chemotherapy; Sequential; Advanced gastric cancer
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