摘要
目的：为研究新辅助介入化疗治疗进展期胃癌的术后病理变化及临床疗效。方法对50例进展期胃癌随机分为两组，研究组25例行含奥沙利铂的动脉灌注化疗；对照组25例行全身静脉化疗。前者采用seldinger技术，根据癌灶部位选择相应的动脉插管，化疗方案选择奥沙利铂85mg/m2，替加氟1000mg/m2、阿霉素25mg/m2。两周期后7-10天手术治疗；后者25例患者选择奥沙利铂85mg/m2d1，亚叶酸钙200 mg/m2d1-2，氟尿嘧啶400 mg/m2ivd1-2，氟尿嘧啶600 mg/m2 CIVd1-2。两周期全身化疗后10-14天手术治疗，对术后胃癌标本进行组织病理学检查及术后2年生存率。结果两组术后组织病理学改变总有效率分别55.6%，36.52%。两组比较有统计学差异（P<0.05）。2年生存率分别为70%和54.2%两组比较有统计学差异（P<0.05）。结论术前含奥沙利铂的新辅助介入化疗对进展期胃癌是一种安全有效、切实可行的辅助治疗方法，并发症少于全身化疗，对手术切除率和生存率有提高，有待大样本的研究。
Abstract
Objective To study of neoadjuvant chemotherapy for advanced gastric cancer postoperative pathological changes and clinical effect. Methods: 50 cases of advanced gastric cancer were randomly divided into two groups, the study group of 25 cases of arterial infusion chemotherapy with oxaliplatin; the control group of 25 cases of systemic venous chemotherapy. The former uses Seldinger technology, according to lesion location selectivearterial corresponding, oxaliplatin 85mg/m2 chemotherapy regimen tegafur, doxorubicin, 1000mg/m2 25mg/ m2. The two cycle 7-10 days after operation treatment; the latter 25 patients selected 85mg/m2 D1 oxaliplatin, calcium folinate 200 mg/m2 D1-2, fluorouracil 400 mg/m2ivd1-2, 600 mg/m2 CIVd1-2 fluorouracil. The two cycle of chemotherapy treatment 10-14 days after operation, the postoperative gastric cancer specimens for examination and surgery pathology after 2 year survival rate. Results: the two groups of postoperative pathology change and total effective rate were 55.6%, 36.52%. A significant difference between two groups (P < 0.05). The 2 year survival rates were 70% and 54.2%, a significant difference between two groups (P < 0.05). Conclusion: neoadjuvant preoperative interventional chemotherapy containing oxaliplatin is a safe, effective, feasible treatment method for advanced gastric cancer, complications less than systemic chemotherapy, the operation resection rate and survival rate increased, to study the large sample.
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