中国现代医生2024,Vol.62Issue(34) :24-28,57.DOI:10.3969/j.issn.1673-9701.2024.34.006

真实世界局部晚期胃癌新辅助化疗的疗效及安全性

Efficacy and safety of real world neoadjuvant chemotherapy for locally advanced gastric cancer

赵浩森 曲颜丽
中国现代医生2024,Vol.62Issue(34) :24-28,57.DOI:10.3969/j.issn.1673-9701.2024.34.006

真实世界局部晚期胃癌新辅助化疗的疗效及安全性

Efficacy and safety of real world neoadjuvant chemotherapy for locally advanced gastric cancer

赵浩森 1曲颜丽1
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作者信息

  • 1. 新疆医科大学附属肿瘤医院消化内科,新疆乌鲁木齐 8300001
  • 折叠

摘要

目的 探讨局部晚期胃/胃食管结合部腺癌患者两药/三药新辅助化疗(neoadjuvant chemotherapy,NACT)的疗效及安全性.方法 选取2016年1月至2021年12月新疆医科大学附属肿瘤医院收治的112例局部晚期胃/胃食管结合部腺癌患者为研究对象,根据患者的NACT方案将其分为两药组(36例)和三药组(76例).所有患者均行至少2个周期的NACT,之后接受手术治疗.比较两组患者的治疗疗效、无病生存期(disease-free survival,DFS)和总生存(overall survival,OS).结果 三药组患者的部分缓解占比显著高于两药组(P<0.05).两组患者的OS、DFS、R0切除率、肿瘤降级比较差异均无统计学意义(P>0.05);多因素Cox回归分析结果显示,手术方法、病理分化类型、术后肿瘤病理分期、神经侵犯均是影响患者OS的独立危险因素(P<0.05),年龄、手术方法、术后肿瘤病理分期均是影响患者DFS的独立危险因素(P<0.05).三药组患者的严重贫血比例显著高于两药组(P<0.05),其余不良反应两组间比较差异均无统计学意义(P>0.05).结论 两药/三药NACT方案对患者的远期预后无显著影响,但患者的年龄、术后肿瘤病理分期、病理分化类型对患者的预后有一定影响.

Abstract

Objective To investigate the efficacy and safety of two-drug/three-drug neoadjuvant chemotherapy (NACT) for patients with locally advanced gastric/gastroesophageal junction adenocarcinoma. Methods A total of 112 patients with locally advanced gastric/gastroesophageal junction adenocarcinoma admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from January 2016 to December 2021 were selected as study objects,and were divided into two-drug group (36 cases) and three-drug group (76 cases) according to the NACT regimen. All patients underwent at least 2 cycles of NACT followed by surgery. The therapeutic effect,disease-free survival (DFS) and overall survival (OS) were compared between two groups. Results The proportion of partial response in three-drug group was significantly higher than that in two-drug group (P<0.05). There were no significant differences in OS,DFS,R0 resection rate and tumor degradation between two-drug and three-drug groups (P>0.05). Multivariate Cox regression analysis showed that surgical method,pathological differentiation type,pathological stage of postoperative tumor,and nerve invasion were independent risk factors for OS (P<0.05),age,surgical method and pathological stage of postoperative tumor were independent risk factors for DFS (P<0.05). The proportion of severe anemia in three-drug group was significantly higher than that in two-drug group (P<0.05),and there were no significant differences in other adverse reactions between two groups (P>0.05). Conclusion The two-drug/three-drug NACT regimen have no significant effect on the long-term prognosis of patients,but the patient's age,pathological stage of postoperative tumor and pathological differentiation type have certain effects on the prognosis of patients.

关键词

局部晚期胃癌/新辅助化疗/肿瘤降级

Key words

Locally advanced gastric cancer/Neoadjuvant chemotherapy/Tumor downgrade

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出版年

2024
中国现代医生
中国医学科学院

中国现代医生

影响因子:1.571
ISSN:1673-9701
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