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目的研究术前短程冲击化疗对进展期胃癌肿瘤细胞凋亡的影响。方法2004年6月至2005年4月间,共有28例未经治疗的局部进展期胃癌患者入组本次临床研究。入组病例中随机抽取18例患者行以多帕菲70-75mg/m2,第一天使用,静滴;顺铂20mg/天d1～5天,静滴;5-FU0.75/天,d1～5天,静滴,为主的术前短程冲击化疗方案一个疗程治疗,10例为空白对照组。观察术前短程冲击化疗后原发病灶中肿瘤细胞的凋亡指数,并观察术前短程冲击化疗的毒副反应。结果术前短程冲击化疗后所有病人行根治性手术治疗,术后化疗组肿瘤细胞的凋亡指数明显高于对照组(P<0.01)。毒副反应主要为白细胞减少症,腹泻,恶心呕吐,脱发等,所有18例行术前化疗的患者的白细胞减少症都在0～I级,且所有行术前化疗患者在结束一个疗程的术前短程冲击化疗后均能行正常手术。结论术前短程冲击化疗对进展期胃癌近期疗效显著,能诱导肿瘤细胞凋亡,是一种简便可行安全高效的胃癌治疗方法,且耐受性良好,化疗导致的毒副作用较轻,在结束短程冲击化疗后均能行手术治疗,术后恢复良好。
Objective To study the effect of preoperative short-range impact chemotherapy on the apoptosis of advanced gastric cancer cells. Methods Between June 2004 and April 2005, a total of 28 untreated patients with locally advanced gastric cancer were enrolled in this study. In the group of patients, 18 patients were randomly assigned to take dipyridamole 70-75mg / m2 on the first day, intravenous infusion; cisplatin 20mg / day d1 ~ 5 days, intravenous infusion; 5-FU0.75 / day, d1 ~ 5 days, intravenous infusion, based preoperative short-range impact chemotherapy regimen a course of treatment, 10 cases of blank control group. The apoptosis index of tumor cells in the primary lesion before and after short-term impact chemotherapy was observed, and the toxicity of the short-term impact chemotherapy before operation was observed. Results All the patients underwent radical surgery after short-range impact chemotherapy. The apoptosis index of tumor cells in the chemotherapy group was significantly higher than that in the control group (P <0.01). The main side effects were leucopenia, diarrhea, nausea and vomiting, hair loss and so on. All 18 patients with preoperative chemotherapy had grade 0 to 1 leukopenia, and all patients undergoing preoperative chemotherapy were at the end of a course of treatment Before short-stroke impact chemotherapy can be normal surgery. Conclusion The short-term impact of preoperative short-term impact on the treatment of advanced gastric cancer significant effect, can induce apoptosis of tumor cells is a simple and feasible safe and efficient treatment of gastric cancer, and well tolerated, chemotherapy-induced side effects of light, at the end of short-range After the impact of chemotherapy can be surgically treated, postoperative recovery is good.