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为了观察局部进展期胃癌术后同步放化疗的疗效及不良反应,对74例局部进展期胃癌术后患者,随机分为对照组和观察组各37例,对照组单纯采用奥沙利铂、亚叶酸钙联合5-氟尿嘧啶辅助化疗;观察组采用同步放化疗,放射治疗采用6MV X线,放射总剂量30～40Gy/(3～5周)。结果观察组的1、2和3年生存率分别为75.7%、64.9%和54.1%,对照组为67.6%、43.2%和27.0%,差异有统计学意义,χ2=16.81,P=0.02。观察组的3年无瘤生存率(59.6%)显著高于对照组(21.6%),χ2=11.62,P=0.03。不良反应主要为骨髓抑制和胃肠道反应,观察组胃肠道反应的发生率显著高于对照组,χ2=7.94,P=0.01。初步研究结果提示,术后同步放化疗可以提高局部进展期胃癌患者的生存率,且不良反应可耐受,值得在临床借鉴。
In order to observe the efficacy and adverse reactions of concurrent chemoradiotherapy after locally advanced gastric cancer, 74 patients with locally advanced gastric cancer were randomly divided into control group and observation group, 37 cases in each group. The control group was treated with oxaliplatin alone Folic acid combined with 5-fluorouracil adjuvant chemotherapy; observation group with concurrent chemoradiotherapy, radiation therapy using 6MV X-ray, the total radiation dose of 30 ~ 40Gy / (3 ~ 5 weeks). Results The 1-, 2-, and 3-year survival rates of the observation group were 75.7%, 64.9% and 54.1%, respectively, and those in the control group were 67.6%, 43.2% and 27.0%, respectively, with a statistically significant difference χ2 = 16.81, P = 0.02. The 3-year disease-free survival rate (59.6%) in the observation group was significantly higher than that in the control group (21.6%), χ2 = 11.62, P = 0.03. The main adverse reactions were myelosuppression and gastrointestinal reactions. The incidence of gastrointestinal reactions in the observation group was significantly higher than that in the control group (χ2 = 7.94, P = 0.01). Preliminary results suggest that postoperative concurrent chemoradiotherapy can improve the survival rate of patients with locally advanced gastric cancer, and adverse reactions are tolerable, it is worth in the clinical reference.