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目的:探讨进展期胃上部癌术前放化疗的短期有效性、治疗安全耐受性及生存预后情况。方法:回顾性分析北京大学肿瘤医院胃肠肿瘤外科2011年11月至2014年11月间收治的行术前放化疗或术前化疗并后续标准D2根治手术的62例进展期胃上部癌患者病历资料,分析比较两组患者各项短期疗效指标、安全性指标及不良反应的差异,并进行随访资料的生存分析。结果:术后病理结果中术前放化疗组pT_4期及p N_3患者数量明显减少(P<0.05),手术安全性及放化疗不良反应两组间差异无统计学意义,生存分析两组间差异无统计学意义。结论:术前放化疗可改良胃上部癌患者生存预后。相较于术前化疗,术前放化疗没有增加手术难度及风险,放化疗毒性在可控范围内。术前放化疗能有效提高局部控制率尤其是区域淋巴转移,其客观缓解率与术前化疗相当。但是,生存预后的最终结论仍有待于长期随访的进一步分析。
Objective: To investigate the short-term efficacy of preoperative chemoradiotherapy, safety of treatment and survival and prognosis of patients with advanced gastric cancer. Methods: A retrospective analysis of 62 patients with advanced gastric cancer who underwent preoperative chemoradiation or preoperative chemotherapy followed by standard D2 radical surgery admitted to the Department of Gastrointestinal Cancer at Peking University Cancer Hospital from November 2011 to November 2014 was retrospectively analyzed. Data, analysis of the two groups of patients with short-term efficacy indicators, safety indicators and adverse reactions, and follow-up data survival analysis. Results: The number of pT_4 and pN_3 patients in the preoperative radiotherapy and chemotherapy group was significantly decreased (P <0.05). There was no significant difference between the two groups in the safety of operation and adverse reactions of radiotherapy and chemotherapy. The difference of survival analysis between the two groups No statistical significance. Conclusion: Preoperative chemoradiotherapy can improve the prognosis of patients with gastric cancer. Compared with preoperative chemotherapy, preoperative radiotherapy and chemotherapy did not increase the difficulty and risk of surgery, radiotherapy and chemotherapy toxicity in the controllable range. Preoperative chemoradiotherapy can effectively improve the local control rate, especially regional lymphatic metastasis, the objective response rate and preoperative chemotherapy. However, the final prognosis of survival remains to be further analyzed by long-term follow-up.