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目的探讨新辅助化疗联合手术治疗进展期胃癌的临床疗效和安全性。方法选取66例进展期胃癌患者,随机分为观察组和对照组,每组33例,观察组患者术前行新辅助化疗(FOLFOX方案)。两组患者均择期进行手术治疗,比较两组患者手术切除效果、术后并发症和生存时间。结果观察组患者均完成新辅助化疗,完全缓解率为24.2%(8/33),总有效率为60.6%(20/33),疾病控制率为84.8%(28/33)。3~4级不良反应主要为呕吐、肝功能异常、血红蛋白降低、中性粒细胞减少和食欲减退。观察组患者的手术根治性切除率为75.8%(25/33),显著高于对照组(51.5%,17/33);住院时间低于对照组,差异有统计学意义(P<0.05)。观察组患者并发症发生率为21.2%(7/33),低于对照组(24.2%,8/33),但差异无统计学意义(P>0.05)。结论进展期胃癌患者进行新辅助化疗可有效提高根治率,减少手术并发症,值得临床进一步推广。
Objective To investigate the clinical efficacy and safety of neoadjuvant chemotherapy in the treatment of advanced gastric cancer. Methods Sixty - six patients with advanced gastric cancer were selected and randomly divided into observation group and control group, with 33 cases in each group. The observation group received preoperative adjuvant chemotherapy (FOLFOX). Both groups of patients underwent elective surgical treatment. The surgical resection effect, postoperative complications and survival time were compared between the two groups. Results The patients in the observation group received neoadjuvant chemotherapy. The complete remission rate was 24.2% (8/33), the total effective rate was 60.6% (20/33) and the disease control rate was 84.8% (28/33). Grade 3 to 4 adverse reactions are mainly vomiting, abnormal liver function, decreased hemoglobin, neutropenia and loss of appetite. The radical resection rate in the observation group was 75.8% (25/33), which was significantly higher than that in the control group (51.5%, 17/33). The length of stay in the observation group was lower than that in the control group (P <0.05). The complication rate in observation group was 21.2% (7/33), which was lower than that in control group (24.2%, 8/33), but the difference was not statistically significant (P> 0.05). Conclusions Neoadjuvant chemotherapy in patients with advanced gastric cancer can effectively improve the cure rate and reduce the complication of surgery, so it is worth further clinical promotion.