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目的探讨Ⅱ、Ⅲ期胃癌患者D2根治术后辅助化疗与Ⅱ、Ⅲ期胃癌患者预后的关系。方法将326例行D2根治术的Ⅱ、Ⅲ期胃癌患者按照根治术后是否接受术后辅助化疗、化疗周期数以及化疗方案进行分组,比较各组的5年生存率有无差异。结果全组患者的5年总生存率为52%,化疗组和未化疗组的5年总生存率分别为58%和48%(χ2=2.876,P=0.090);化疗0周期(组一)、1-3周期(组二)、4周期及以上(组三)的5年生存率依次为48%、49%、68%,整体比较差异无统计学意义(χ2=5.957,P=0.051),仅组一与组三比较差异有统计学意义(χ2=5.908,P=0.015)。辅助化疗患者使用m DCF、FOLFOX和其它方案,3组的5年生存率依次为50%、60%、61%(χ2=0.290,P=0.865)。结论Ⅱ、Ⅲ期胃癌患者在D2根治术后给予不少于4周期的辅助化疗能提高其总生存率,但m DCF、FOLFOX和其它化疗方案之间未见明显差异。
Objective To investigate the relationship between postoperative adjuvant chemotherapy after D2 radical resection and the prognosis of stage Ⅱ and Ⅲ gastric cancer patients with stage Ⅱ and Ⅲ gastric cancer. Methods A total of 326 patients with stage II and III gastric cancer undergoing D2 radical resection were divided into two groups according to whether they received postoperative adjuvant chemotherapy, the number of cycles of chemotherapy, and the chemotherapy regimen. All five-year survival rates were compared between groups. Results The 5-year overall survival rate was 52% in all patients, and the 5-year overall survival rate was 58% and 48% in chemotherapy group and non-chemotherapy group (χ2 = 2.876, P = 0.090) (Χ2 = 5.957, P = 0.051). The 5-year survival rates of 1-3 cycles (group 2), 4 cycles and above (group 3) were 48%, 49% and 68% , Only group one and group three, the difference was statistically significant (χ2 = 5.908, P = 0.015). The 5-year survival rates of the three groups were 50%, 60% and 61%, respectively (χ2 = 0.290, P = 0.865) for adjuvant chemotherapy using m DCF, FOLFOX, and other regimens. Conclusions Adjuvant chemotherapy of not less than 4 cycles after radical resection of D2 patients with stage II and III gastric cancer can increase the overall survival rate. However, there is no significant difference between m DCF, FOLFOX and other chemotherapy regimens.