| Qiang Fu,Shiying Yu,Guoqing Hu,Yuan Chen,Junbo Hu,Lihong Zhang,Hong Qiu,Xianglin Yuan. Postoperative sequential chemotherapy and radiotherapy for locally advanced gastric cancer. Oncol Transl Med, 2018, 4: 85-92. |
| 进展期胃癌术后辅助序贯放化疗临床研究 |
| Postoperative sequential chemotherapy and radiotherapy for locally advanced gastric cancer |
| Received:March 22, 2018 Revised:July 12, 2018 |
| DOI：10.1007/s10330-018-0261-1 |
| 中文关键词: 进展期胃癌，序贯化疗，放疗，生存率 |
| 英文关键词: advanced gastric cancer; sequential chemotherapy; radiotherapy; survival rate |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Qiang Fu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | fuqiang_tjh@126.com | | Shiying Yu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Guoqing Hu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Yuan Chen | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Junbo Hu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Lihong Zhang | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Hong Qiu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Xianglin Yuan* | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | xlyuan1020@163.com |
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| 中文摘要: |
| 目的：探讨进展期胃癌术后辅助化疗序贯放疗的疗效。
方法：2003年1月至2010年12月，收集我院放疗中心146例行根治性手术后化疗序贯放疗的胃癌患者，放射治疗剂量为4500cGy/25次，切缘阳性患者，手术残端剂量推量至5040cGy/28次。放疗前后各行3周期mFOLFOX或PF（顺铂、氟尿嘧啶）方案化疗。统计患者3年和5年总生存率（OS）和无病生存率（DFS），并观察治疗过程中出现的血液学、肝肾功能以及胃肠道不良反应。
结果：本组包括104名男性和42名女性患者，中位年龄为51岁。完成术后化疗序贯放疗（4500 cgy-5040 cGy）共129例（88.4%）。随访期间观察到17例患者（9.8%）区域复发和46例患者（23.8%）远处转移。随访期间死亡患者50例（34.2%）。3年和5年总生存率（OS）分别为60%和54%，3年和5年无病生存率（DFS）分别为53%和47%。生存率与年龄、性别、病理组织学、N分期、肿瘤部位及边缘状况无显著性差异。多因素分析显示，只有肿瘤浸润深度（T分期）是影响OS（P＝0.009）和DFS（P＝0.006）的独立预后因素。治疗期间患者3-4级中性粒细胞减少症的发生率为9.6%，3-4级呕吐的发生率为3.4%。
结论： 术后mFOLFOX或 PF方案化疗序贯放疗是治疗T3-4胃癌患者的有效手段，不良反应可耐受。 |
| 英文摘要: |
| Objective The aim of the study was to evaluate the role of postoperative sequential chemotherapy and
radiotherapy in patients with locally advanced gastric cancer.
Methods From January 2003 to December 2010, 146 gastric cancer patients at our institution (Department
of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China) received postoperative sequential chemotherapy and radiotherapy after radical surgery.
Radiotherapy was administered as a dose of 4500 cGy in 25 fractions. For patients with positive margins,
the dose was raised to 5040 cGy in 28 fractions. Three cycles of mFOLFOX or PF (cisplatin, 5-fluorouracil)
chemotherapy regimen were applied before and after radiotherapy. Three- and 5-year survival rates were
analyzed; any adverse effects with respect to hematology, hepatic and renal function, or the gastrointestinal
tract that occurred during the treatment were evaluated.
Results This cohort consisted of non-metastatic patients: 104 men and 42 women with a median
age of 51.0 years. The full course of sequential chemotherapy and radiotherapy (4500–5040 cGy) was
completed by 129 patients (88.4%). Seventeen regional relapses (9.8%) and 46 distant relapses (23.8%)
were recorded. Fifty patients (34.2%) died during follow-up. The 3- and 5-year overall survival rates (OS)
were 60% and 54%, and disease-free survival rates (DFS) were 53% and 47%, respectively. There were
no significant differences in survival rate with respect to age, sex, histopathology, N stage, site of the
tumor, or margin status. Multivariate analysis showed that only the depth of tumor invasion (T stage) was
an independent prognostic factor for OS (P = 0.009) and DFS (P = 0.006). The rates of grades 3 and 4
neutropenia and vomiting were 9.6% and 3.4%, respectively, during the treatment.
Conclusion Postoperative sequential chemotherapy with an mFOLFOX or PF regimen and radiotherapy
were found to be an effective means of treating advanced gastric cancer patients with T3–T4 disease. The
adverse effects of this treatment were tolerable. |
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