局部晚期胃癌序贯放化疗与单纯化疗的临床随机观察.doc

局部晚期胃癌序贯放化疗与单纯化疗的临床随机观察 王建芳,吴东平,孙彩萍 作者单位:312000 浙江绍兴,绍兴市人民医院放疗科 【摘要】 目的 评价序贯放化疗对局部晚期不能手术切除胃癌的近期疗效及毒副反应、生活质量、生存的影响。方法 收集我院2004-02-2007-8局部不能手术切除的晚期胃癌序贯放化疗31例及对照单纯化疗患者29例, 分析两组的近期疗效、生活质量改善率及1年生存率, 同时评价放化疗期间出现的血液学, 肝肾功能及胃肠道等不良反应。结果 序贯放化疗组和单纯化疗组的近期有效率分别为61%和48%,1年生存率分别为68%和45%,中位生存时间分别为15.7个月和10.3个月, 治疗期间两组出现Ⅲ-Ⅳ级白细胞减少分别为12.9%和4.9%, Ⅲ-Ⅳ级恶心呕吐分别为9.6.3%和3.4%, 但差异无统计学意义。结论 局部晚期胃癌患者序贯放化疗较单纯化疗有效率高,生活质量得到改善,提高1年生存率, 延长中位生存时间,不良反应可耐受 【关键词】 进展期胃癌 序贯放化疗 FOLFOX方案 疗效 生活质量 生存率 Clinical observation on effect of sequence chemoradiotherapy compared with chemotherapy alone in treating unresectable gastric cancer WANG jian-fang,WU dong-ping,SHUN chai-ping. Radiotherapy centre of the peoples hospital of shao xing ，zhejiang china。 【Abstract】Objective To investigate the effect of sequence chemoradiotherapy compared with chemotherapy alone on the response rate and QOL(quality of life) and survival of patients with unresectable gastric cancer,and to evaluate the toxicity.；【Methods】 A total of 60 patients were collected from our hospital from February 2004 to August 2007.Thirty-one patients received sequence chemoradiotherapy and 29 received chemotherapy alone. The quality of life was observed.The response rate and 1-yr survival rate were evaluated, as well as the hematologic and gastrointestinal toxic effects, liver and kidney function. 【Results】:The response rate and 1-yr survival rate of the sequence chemoradiotherapy group was 61%and 68%, respectively, as compared with chemotherapy alone was 48% and 45%.The median survival time was 15.7month compared with 10.3 month in the control group(P = 0.038). Grade Ⅲ–Ⅳ leukopenia occurred in 11.1% of the sequence chemoradiotherapy group compared with 6.3% in the control group.Grade Ⅲ–Ⅳ nausea and vomiting occurred in 12.9% compared with 4.9% in the control group.No statistic significant correlation was found in toxic effect.CONCLUSION Sequence chemoradiotherapy for gastric cancer improves the response rate and 1-yr survival rate sig