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目的:回顾性分析辅助化疗FOLFOX4方案与FLP方案治疗食管胃结合部癌根治术后患者的疗效和不良反应。方法:回顾性分析2007年3月-2009年10月共123例接受FOLFOX4方案(67例)或FLP方案(56例)辅助化疗的食管胃结合部癌根治术后患者。主要评价指标为无病生存期(disease-free survival,DFS)、总生存期(overall survival,OS)和不良反应。同时,对两组患者的疗效进行分层分析。结果:FOLFOX4方案组和FLP方案组的中位DFS分别为35.9和16.8个月(P=0.008),中位OS分别为41.3和25.6个月(P=0.013)。分层分析显示,男性、45～65岁、腺癌以及Ⅱ期或ⅢA期患者接受FOLFOX4方案术后辅助化疗较FLP方案更具生存优势。FOLFOX4和FLP方案均耐受良好,血液学不良反应发生率无明显差异。FOLFOX4方案组非血液学不良反应主要为外周神经毒性,FLP方案组主要为消化系统反应。结论:与FLP方案相比,FOLFOX4方案辅助化疗可明显延长食管胃结合部癌术后患者的DFS和OS,且不良反应可耐受。
OBJECTIVE: To retrospectively analyze the efficacy and side effects of adjuvant chemotherapy with FOLFOX4 regimen and FLP regimen in the treatment of patients with radical resection of esophagogastric junction. Methods: From March 2007 to October 2009, 123 patients undergoing radical resection of esophagogastric junction cancer with FOLFOX4 regimen (67 patients) or FLP regimen (56 patients) undergoing radical resection were retrospectively analyzed. The main evaluation indicators were disease-free survival (DFS), overall survival (OS) and adverse reactions. At the same time, the two groups of patients were stratified analysis of the efficacy. Results: The median DFS were 35.9 and 16.8 months in the FOLFOX4 and FLP groups (P = 0.008), respectively. The median OS was 41.3 and 25.6 months, respectively (P = 0.013). Hierarchical analysis showed that men, 45-65 years of age, adenocarcinoma, and patients with stage II or IIIA FOLFOX4 postoperative adjuvant chemotherapy had more survival advantages than the FLP regimen. FOLFOX4 and FLP regimen were well tolerated, no significant difference in the incidence of adverse reactions to hematology. In the FOLFOX4 regimen, non-hematologic adverse reactions were mainly peripheral neurotoxicity, while FLP regimen was predominantly digestive. CONCLUSIONS: Compared with the FLP regimen, adjuvant chemotherapy with FOLFOX4 regimen can significantly prolong the DFS and OS of esophagogastric junction cancer patients after operation, and the adverse reactions are tolerable.