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目的观察紫杉醇联合顺铂新辅助化疗对胃癌患者的疗效和安全性。方法选取2009年10月至2011年7月间南宫市人民医院收治的64例胃癌患者,采用随机数字表法分为治疗组与对照组,每组32例。治疗组患者术前采用紫杉醇联合顺铂化疗2个周期,化疗结束后进行手术治疗。对照组患者直接进行手术切除。对比两组患者根治性切除率、术后病理分期与术前临床分期差异、术后并发症发生率及术后2年生存率。结果两组患者均顺利完成手术,治疗组患者手术根治性切除率为87.5%,术后并发症发生率为12.5%,术后2年生存率为71.9%,对照组患者上述指标分别为65.6%、9.4%和46.9%,两组患者根治性切除率和术后2年生存率比较,差异均有统计学意义(均P<0.05),而术后并发症发生率比较,差异无统计学意义(P>0.05)。治疗组中有10例患者术后病理分期低于术前临床分期,对照组患者中有2例,两组比较,差异有统计学意义(P<0.05)。结论术前紫杉醇联合顺铂新辅助化疗能提高胃癌根治性切除率,降低病理分期,提高患者生存率,且安全性较高,值得临床推广应用。
Objective To observe the efficacy and safety of paclitaxel combined with cisplatin neoadjuvant chemotherapy in patients with gastric cancer. Methods Sixty-four patients with gastric cancer who were admitted to Nangong People’s Hospital from October 2009 to July 2011 were randomly divided into treatment group and control group, with 32 cases in each group. Patients in the treatment group were treated with paclitaxel combined with cisplatin two cycles preoperatively and surgery was performed after the chemotherapy. Patients in the control group underwent surgical resection directly. Radical resection rate, postoperative pathological staging and preoperative clinical stage difference, postoperative complication rate and postoperative 2-year survival rate were compared between the two groups. Results The two groups of patients completed the operation successfully. The radical resection rate was 87.5%, the postoperative complication rate was 12.5% and the 2-year survival rate was 71.9% in the two groups. The above indexes in the control group were 65.6% , 9.4% and 46.9% respectively. There was significant difference between the two groups in the radical resection rate and the 2-year survival rate after operation (both P <0.05), while the incidence of postoperative complications was not statistically significant (P> 0.05). There were 10 cases in the treatment group with less pathological stage than the preoperative clinical stage, 2 cases in the control group. There was significant difference between the two groups (P <0.05). Conclusions Neoadjuvant chemotherapy with paclitaxel plus cisplatin can improve the radical resection rate of gastric cancer, reduce the pathological stage and improve the survival rate of patients with high safety. It is worthy of clinical application.