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目的观察进展期胃癌术后调强放疗联合同期化疗的临床效果。方法进展期胃癌根治术后患者180例,随机分为对照组和观察组各90例,对照组接受FOLFOX4方案,全部患者接受2～3周期化疗;观察组在对照组的基础上实施调强放疗,PTV边缘的处方剂量为50 Gy。结果观察组完全缓解4例,部分缓解46例,无变化37例,进展3例,完全缓解+部分缓解占55.6%;对照组分别为2、36、44和8例,完全缓解+部分缓解占40.0%。观察组近期疗效优于对照组(P<0.05)。观察组白细胞分级:Ⅰ级34例、Ⅱ级12例、Ⅲ级7例和Ⅳ级1例;对照组分别为32例、13例、6例和2例。两组比较无显著性差异(χ2=0.67,P>0.05)。观察组发生急性放射反应4例,能够耐受。结论进展期胃癌术后实施调强放疗联合同期化疗与常规化疗相比,提高近期疗效完全缓解+部分缓解率,急性毒副反应可以耐受,可以推荐临床应用。
Objective To observe the clinical effect of postoperative IMRT combined with concurrent chemotherapy in advanced gastric cancer. Methods 180 cases of advanced gastric cancer after radical operation were randomly divided into control group and observation group 90 cases, the control group received FOLFOX4 program, all patients received 2 to 3 cycles of chemotherapy; the observation group in the control group based on the implementation of intensity-modulated radiotherapy The prescription dose at the PTV margin was 50 Gy. Results The observation group was completely relieved in 4 cases, partially relieved in 46 cases, unchanged in 37 cases, progression in 3 cases, complete remission + partial remission accounted for 55.6%; control group were 2,36,44 and 8 cases, complete remission + partial remission accounted 40.0%. The observation group had better curative effect than the control group (P <0.05). The observation group, white blood cell classification: Ⅰ grade 34 cases, Ⅱ grade 12 cases, Ⅲ grade 7 cases and Ⅳ grade 1 case; control group were 32 cases, 13 cases, 6 cases and 2 cases. There was no significant difference between the two groups (χ2 = 0.67, P> 0.05). Observation group acute radiation reaction in 4 cases, able to tolerate. Conclusions Compared with conventional chemotherapy, the treatment of advanced gastric cancer with IMRT combined with concurrent chemotherapy improves the complete remission, partial remission rate and acute side effects of short-term curative effect and can be recommended for clinical application.