目的:局部进展期胃癌,即使没有出现远处转移或腹膜种植,预后也极不理想。我们对局部进展期胃癌患者进行术前mECF方案的动静脉结合化疗,以评价其治疗疗效。方法:选取自2009年1月至2011年6月间我院局部进展期胃癌II-IIIC期患者38例,均由影像学确定淋巴结高度可疑转移或浸润、包绕主要血管结构,且没有发现远处转移或腹膜种植,进行2个周期的术前动静脉结合化疗后,行手术治疗。记录化疗毒性反应、临床、病理缓解率、手术并发症发生率和病死率以及1年无病生存率。结果:化疗毒性反应低,3级反应不超过10%,仅有1例出现4级反应,表现为腹泻、恶心和呕吐。38例患者中临床CR有6例,占15.8%,PR17例,占44.7%,NC13例(34.2%),PD2例(5.3%),RR为60.5%(23/38)。全部患者均施行了手术,37例患者进行了根治性手术,R0切除率为97%。病理缓解率为5例完全缓解(13.2%),21例部分缓解(55.3%),8例轻微缓解(21.1%),4例未缓解(10.5%)。手术并发症发生率为7.9%,无治疗相关死亡发生。1年无病生存率为81.6%。结论:局部进展期胃癌患者术前进行mECF方案的动静脉化疗毒性反应低,疗效理想,之后行手术完整切除后临床效果突出,是理想的治疗方法。 OBJECTIVE: Local advanced gastric cancer, even without distant metastasis or peritoneal implantation, has a very poor prognosis. We conducted preoperative mECF regimen of arteriovenous and chemotherapy in patients with locally advanced gastric cancer to evaluate its efficacy. Methods: Thirty-eight patients with locally advanced gastric cancer in stage II-IIIC from January 2009 to June 2011 were confirmed suspicious metastasis or infiltration of lymph nodes by imaging, and the main vascular structures were not found Distant metastasis or peritoneal implantation, 2 cycles of preoperative arteriovenous and chemotherapy, surgical treatment. Toxicity of chemotherapy, clinical, pathological response rate, incidence of complications and mortality and 1-year disease-free survival rate were recorded. Results: Toxicity of chemotherapy was low, grade 3 reaction did not exceed 10%, and grade 1 reaction only appeared in grade 4, which showed diarrhea, nausea and vomiting. Of the 38 patients, clinical CR was found in 6 cases (15.8%), PR17 cases (44.7%), NC13 cases (34.2%) and PD2 cases (5.3%) with RR of 60.5% (23/38). All patients underwent surgery, and 37 patients underwent radical surgery with an R0 resection rate of 97%. Pathological remission rates were 5 (13.2%), 21 (55.3%), 8 (21.1%) and 4 (10.5%). The complication rate was 7.9% and no treatment-related death occurred. One year disease-free survival rate was 81.6%. Conclusion: The preoperative chemotherapy of mECF in patients with locally advanced gastric cancer has low toxicity and satisfactory curative effect. After the complete resection, the clinical effect is outstanding, which is an ideal treatment.