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新辅助化疗FOLFOX4方案治疗进展期胃癌的临床疗效

孙 震, 杨肖军, 程伏林, 杨国樑, 熊 斌, 李 雁

孙 震, 杨肖军, 程伏林, 杨国樑, 熊 斌, 李 雁. 新辅助化疗FOLFOX4方案治疗进展期胃癌的临床疗效[J]. 肿瘤防治研究, 2014, 41(07): 803-807. DOI: 10.3971/j.issn.1000-8578.2014.07.025
引用本文: 孙 震, 杨肖军, 程伏林, 杨国樑, 熊 斌, 李 雁. 新辅助化疗FOLFOX4方案治疗进展期胃癌的临床疗效[J]. 肿瘤防治研究, 2014, 41(07): 803-807. DOI: 10.3971/j.issn.1000-8578.2014.07.025
SUN Zhen, YANG Xiaojun, CHENG Fulin, YANG Guoliang, XIONG Bin, LI Yan. Clinical Efficacy of Neoadjuvant Chemotherapy with FOLFOX4 Regimen in Advanced Gastric Carcinoma[J]. Cancer Research on Prevention and Treatment, 2014, 41(07): 803-807. DOI: 10.3971/j.issn.1000-8578.2014.07.025
Citation: SUN Zhen, YANG Xiaojun, CHENG Fulin, YANG Guoliang, XIONG Bin, LI Yan. Clinical Efficacy of Neoadjuvant Chemotherapy with FOLFOX4 Regimen in Advanced Gastric Carcinoma[J]. Cancer Research on Prevention and Treatment, 2014, 41(07): 803-807. DOI: 10.3971/j.issn.1000-8578.2014.07.025

新辅助化疗FOLFOX4方案治疗进展期胃癌的临床疗效

基金项目: 教育部博士点专项研究基金资助项目(20120141110042)
详细信息
    作者简介:

    孙震(1988-),男,硕士在读,主要从事胃肠道肿瘤综合防治新技术研究

    通信作者:

    李雁,E-mail:liyansd2@163.com

  • 中图分类号: R735.2

Clinical Efficacy of Neoadjuvant Chemotherapy with FOLFOX4 Regimen in Advanced Gastric Carcinoma

  • 摘要: 目的 评价FOLFOX4新辅助化疗方案(氟尿嘧啶、亚叶酸钙和奥沙利铂)治疗进展期胃癌疗效及安全性。方法 本研究为回顾性病例对照研究,按1:1.5比例收集符合标准的患者58例,研究组23例接受FOLFOX4方案新辅助化疗后行手术及辅助化疗,对照组35例直接手术后辅助化疗,比较两组的临床疗效及不良事件。结果 两组临床病理基线数据均衡可比。研究组FOLFOX4方案新辅助化疗的临床缓解率为43.5%。R0切除率(82.6% vs. 82.0%)及淋巴结清扫数[16 (0~49)枚 vs. 13 (3~40)枚]两组差异无统计学意义(P>0.05),淋巴结转移数研究组[3 (0~14)枚]显著少于对照组[6 (0~27)枚] (P=0.04)。研究组和对照组患者中位生存期分别为29.0月(95% CI: 25.3~32.7) vs. 22.0月(95%CI: 18.2~25.8) (P=0.013),三年生存率研究组和对照组分别为73.9% vs. 40.0% (P=0.013)。多因素分析显示,新辅助化疗及肿瘤远处转移是影响预后的独立因素。化疗不良反应主要为血液学及消化道毒性,患者均可耐受,两组间差异无统计学意义(P>0.05)。结论 FOLFOX4方案新辅助化疗可能降低进展期胃癌患者淋巴结转移率,延长生存期,不良事件无显著增加。

     

    Abstract: Objective To evaluate the clinical efficacy and safety of neoadjuvant chemotherapy with FOLFOX4 (5-fluomumcil/leucovorin combined with oxaliplatin) regimen for advanced gastric cancer. Methods Fifty-eight patients with advanced gastric cancer were enrolled, 23 cases in the experimental group (FOLFOX4 regimen neoadjuvant chemotherapy) and 35 cases in control group. The clinical response rate, R0 resection rate, survival data and adverse events were compared between two groups. Results The two groups were well-matched in baseline clinical and pathological data. The clinical response rate was 43.5% in the experimental group. The number of lymph node metastases in the experimental group [3 (0-14)] was significantly less than that in control group [6 (0-27)] (P=0.04). There was no significant differences in R0 resection rate (82.6% vs. 82.0%) or lymph node dissection number[16 (0-49) vs.13 (3-40)] between two groups (P>0.05). The median overall survival (OS) were 29.0 months (95%CI: 25.3-32.7 months) in the experimental group and 22.0 months (95%CI: 18.2-25.8 months) in control group (P=0.013). The 3-year OS rate in the experimental group (73.9%) was significantly higher than that in control group (40.0%). Cox regression multivariate analysis identified neoadjuvant chemotherapy and tumor distant metastasis as independent prognostic factors. Adverse events were mainly hematological and gastrointestinal and were well-tolerated in most cases (P>0.05). Conclusion The FOLFOX4 regimen as neoadjuvant chemotherapy could reduce lymph node metastasis and improve survival without increasing adverse events in patients with advanced gastric cancer.

     

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出版历程
  • 刊出日期:  2014-07-24

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