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目的探讨含紫杉醇脂质体(力朴素)的联合化疗方案行术前区域性动脉灌注治疗进展期胃癌的可行性。方法84例临床诊断Ⅱ期以上进展期胃癌患者在手术前接受区域性动脉灌注化疗,方案为:5-氟尿嘧啶(5-FU)1.0g/m2,顺铂60mg/m2,力朴素135mg/m2;10～14d后接受手术(研究组)。同期收治的78例Ⅱ期以上胃癌患者行常规手术治疗(对照组)。观察新辅助化疗后肿瘤原发病灶的缓解情况、毒副反应,以及两组间的疗效差异。结果对照手术组48例(61.5%)获得根治性切除,1年总生存率为74.3%。新辅助化疗组全部完成术前区域性动脉化疗,毒性作用主要为胃肠道反应和骨髓抑制,均属可控范围内(1～2级);其中66例(78.5%)获得根治性切除,较对照手术组提高17.0%(P=0.018);1年总生存率为80.9%,较对照手术组无显著提高(P=0.283)。结论针对进展期胃癌患者,术前以力朴素联合5-FU、顺铂的方案行动脉介入化疗是安全有效的,它能提高根治手术切除率,但两组近期疗效无显著差异,可能与病例数较少和随访时间有关,尚须继续深入研究。
Objective To investigate the feasibility of preoperative regional arterial infusion in the treatment of advanced gastric cancer with paclitaxel liposome (force Naver) in combination with chemotherapy. Methods Eighty - four patients with advanced gastric cancer with stage Ⅱ or higher underwent regional arterial infusion chemotherapy before surgery. The regimens were: 5 - fluorouracil (1.0 g / m2), cisplatin 60 mg / m2, Surgery was performed after 10 to 14 days (study group). In the same period, 78 patients with stage Ⅱ or higher gastric cancer underwent routine surgery (control group). To observe the neoadjuvant chemotherapy of the primary lesion after remission, toxicity, and the difference between the two groups. Results In the control group, 48 cases (61.5%) received radical resection and the 1-year overall survival rate was 74.3%. Neoadjuvant chemotherapy group completed preoperative regional arterial chemotherapy, the main toxic effects of gastrointestinal reactions and bone marrow suppression, are within the controllable range (1 ~ 2); of which 66 cases (78.5%) were radical resection, Which was 17.0% (P = 0.018) compared with the control group. The 1-year overall survival rate was 80.9%, which was significantly higher than that of the control group (P = 0.283). Conclusion For patients with advanced gastric cancer, preoperative chemotherapy with 5-FU and cisplatin combined with 5-FU and Cisplatin is safe and effective. It can improve the radical resection rate, but there is no significant difference between the two groups in the short-term curative effect, which may be related to the cases Fewer and follow-up time, we must continue to study in depth.