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进展期胃癌患者腹腔镜微创切除术前应用新辅助化疗的效果分析
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| 篇名： | 进展期胃癌患者腹腔镜微创切除术前应用新辅助化疗的效果分析 |
| TITLE： | |
| 摘要： | 目的：观察进展期胃癌患者腹腔镜微创切除术前应用新辅助化疗的疗效和安全性。方法：回顾性分析93例进展期胃癌患者资料，按治疗方案的不同分为单纯组（55例）和联合组（38例）。单纯组患者均行腹腔镜微创切除术治疗。联合组患者于腹腔镜微创切除术前给予亚叶酸钙注射液400 mg/m2+奥沙利铂注射液85 mg/m2，静脉滴注2 h， d1+氟尿嘧啶注射液2 400 mg/m2，静脉滴注46 h，d2，2周为1个疗程，共2～4个疗程，后隔4周行腹腔镜微创切除术。两组患者术后均给予肠外营养、预防性抗炎等常规治疗，并于术后行6个疗程奥沙利铂+卡培他滨方案或替吉奥+奥沙利铂方案化疗。观察联合组患者的临床疗效及不良反应发生情况，两组患者的手术时间、术中失血量、术中输血、切除范围、中转开腹情况、淋巴结清扫数目、完整切除情况、术后首次排气时间、恢复流质进食时间、术后住院天数及并发症发生情况。结果：联合组患者客观缓解率为44.8％，疾病控制率为92.2％，发生Ⅰ级不良反应23例次、Ⅱ级13例次、Ⅲ级3例次。联合组患者完整切除率显著高于单纯组，差异有统计学意义（P＜0.05）；两组患者手术时间、术中失血量、术中输血率、切除范围、中转开腹率、淋巴结清扫数目、术后首次排气时间、恢复流质进食时间、术后住院天数、并发症发生率比较，差异均无统计学意义（P＞0.05）。结论：腹腔镜微创切除术前采用亚叶酸钙、奥沙利铂、氟尿嘧啶新辅助化疗方案用于进展期胃癌的疗效显著，可提高术中完整切除率，且未增加不良反应的发生。 |
| ABSTRACT： | OBJECTIVE： To observe the efficacy and safety of neoadjuvant chemotherapy in advanced gastric carcinoma patients before laparoscopic minimally invasive resction. METHODS： In retrospective analysis， 93 patients with advanced gastric carcinoma were divided into single group （55 cases） and combined group （38 cases）. Single group received laparoscopic minimally invasive operation. Combination group was given Tetrahydrofolate injection 400 mg/m2+Oxaliplatin injection 85 mg/m2，i.v.， 2 h， d1+Fluorouracil injection 2 400 mg/m2， i.v.， 46 h， d2. A treatment course lasted for 2 weeks， both received 2-4 courses of treatment and 4 weeks later received laparoscopic minimally invasive resection. Both groups received routine treatment as parenteral nutrition and preventive anti-inflammation. They were given oxaliplatin+capecitabine or gimeracil oteracil potassium capsule+oxaliplatin chemotherapy for 6 courses. Clinical efficacies and ADR of combination group were observed. Operation time， intraoperative blood loss， intraoperative blood transfusion， resection range， conversions to laparotomy， the number of lymph node dissection， complete resection and postoperative first exhaust time， the time of fluid feeding recovery， the length of hospital stay and complications were observed in 2 groups. RESULTS： The objective remission rate and disease control rate of combination group were 44.8％ and 92.2％； there were 23 case time of grade Ⅰ ADR， 13 case time of grade Ⅱ ADR and 3 case time of grade Ⅲ ADR. Complete resection rate of combination group was significantly higher than that of single group， with statistical significance （P＜0.05）. There was no statistical significance in operation time， intraoperative blood loss， intraoperative blood transfusion， resection range， conversions to laparotomy， the number of lymph node dissection， postoperative first exhaust time， the time of fluid feeding recovery， the length of hospital stay or the incidence of complications between 2 groups （P＞0.05）. CONCLUSIONS： For advanced gastric carcinoma patients before laparosapic minimally invasive resection， tetrahydrofolate， oxaliplatin and fluorouracil neoadjuvant chemotherapy show therapeutic efficacy and can improve the rate of complete resection without increasing the incidence of ADR. |
| 期刊： | 2017年第28卷第27期 |
| 作者： | 杨立平，李晓峰，耿兴隆，秦伟，戴勇，党宝宝，杨生虎，韩云，董晋 |
| AUTHORS： | YANG Liping，LI Xiaofeng，GENG Xinglong，QIN Wei，DAI Yong，DANG Baobao，YANG Shenghu，HAN Yun，DONG Jin |
| 关键字： | 进展期胃癌；新辅助化疗；亚叶酸钙；奥沙利铂；氟尿嘧啶；疗效；安全性 |
| KEYWORDS： | Advanced gastric carcinoma； Neoadjuvant chemotherapy； Tetrahydrofolate； Oxaliplatin； Fluorouracil； Therapeutic efficacy； Safety |
| 阅读数： | 189 次 |
| 本月下载数： | 2 次 |
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