DOS方案治疗进展期胃癌患者围手术期40例

DOS方案治疗进展期胃癌患者围手术期40例

卿三明

【摘要】目的：探讨多西他赛、奥沙利铂联合替吉奥（DOS）的化学治疗(简称化疗)方案对进展期胃癌患者围手术期的影响。方法将收治的进展期胃癌患者80例随机分为对照组和观察组，各40例。对照组给予表阿霉素、顺铂和5－氟尿嘧啶（ECF）方案，观察组给予DOS方案，3周为1个疗程，两组均治疗3个疗程后行手术治疗。结果观察组术中出血量以及术后并发症总发生率显著低于对照组（ P ＜0.05）。观察组R0，R1切除率分别为62.50％和37.50％，显著高于对照组的55.00％和30.00％（ P＜0.05）；观察组R2切除率为0，显著低于对照组的15.00％（ P＜0.05）。观察组总有效率为62.50％，高于对照组的47.50％（ P ＜0.05）。观察组总不良反应发生率明显低于对照组（ P＜0.05）。结论 DOS化疗方案对进展期胃癌患者围手术期具有一定积极影响，能显著减少术中出血量及术后并发症，且近期疗效好，不良反应相对较少。%Objective To investigate the effect of DOS chemotheraPy in treating PerioPerative Patients with advanced gastric cancer. Methods 80 cases of Patients with advanced gastric cancer from June 2012 to January 2014 were randomly divided into the control grouP and the observation grouP, 40 cases in each grouP. The control grouP received ePirubicin, cisPlatin and ECF regimen, and the ob-servation grouP received DOS regimen. 1 treatment course was 3 weeks, and the Patients received surgery after 3 courses of treat-ment. Results The blood loss and the overall incidence of PostoPerative comPlications of the observation grouP were significantly lower than those of the control grouP ( P < 0. 05 ); the R0, R1 resection rates of the observation grouP

were 62. 50% and 37. 50%, which were significantly higher than 55. 00% and 30. 00% of the control grouP ( P < 0. 05 );the R2 resection rate of the observation grouP was 0, which was significantly lower than 15. 00% of the control grouP ( P < 0. 05 ) . The total effective rate of the observation grouP was 62. 50%, which was significantly higher than 37. 50% of the control grouP ( P < 0. 05 ) . The total occurrence rate of adverse reac-tions of the observation grouP was significantly lower than the control grouP ( P < 0. 05 ) . Conclusion DOS chemotheraPy for PerioPera-tive Patients with advanced gastric cancer has certain Positive effect;it can significantly reduce blood loss and PostoPerative comPlica-tions in Patients with good short-term effect and relatively few adverse reactions.

【期刊名称】《中国药业》

【年(卷),期】2015(000)017

【总页数】2页(P90-91)

【关键词】进展期胃癌;围手术期;近期疗效;药品不良反应

【作者】卿三明

【作者单位】四川省宜宾县人民医院，四川宜宾 644000

【正文语种】中文

【中图分类】R969.4;R979.1

流行病学调查显示，全球每年新发胃癌病例高达百万，其中41%发生在中国[1]。虽然手术是胃癌的有效治疗手段，但进展期胃癌根治性手术切除率极低，即使在术

中扩大切除范围和进行彻底的淋巴结清扫，仍不能提高患者远期生存率。对进展期胃癌患者行新辅助化学治疗（简称化疗）可提高手术切除率，避免手术引起的各种并发症[2]。多西他赛、奥沙利铂联合替吉奥（DOS）方案是对胃癌进展期患者进

行化疗的一种新方案[3]。本研究旨在分析选用DOS化疗方案对进展期胃癌患者围手术期的影响，为临床治疗提供依据，现报道如下。

1.1 一般资料

选择2012年6月至2014年6月收治的进展期胃癌患者80

例，纳入标准[4]：术前胃镜活检经病理学诊断已确诊为胃腺癌，且术前评估癌细

胞已侵犯浆膜层但无远处转移；评估患者生存期≥3个月；体能状况(ECOG)评分

为0～2分；TNMⅢa～Ⅳ期；术前查血常规无异常，既往无化疗或放射治疗史。排除标准：ECOG评分＞2分；伴有其他多脏器及远处淋巴结转移；合并有脑血管、心血管、肝肾及造血系统等疾病以及精神病；对本组研究所用药物过敏。本研究经医院伦理委员会批准。将80例患者随机分为观察组和对照组，各 40例。两组患

者一般资料比较，差异无统计学意义（P＞0.05），具有可比性。见表1。

1.2 方法

对照组给予ECF化疗方案，于化疗第1天，静脉滴注表阿霉素(浙江海正药业股份有限公司，国药准字H19990280，规格为每支10 mg)60 mg／m2，化疗第1天至第3天静脉滴注顺铂(Hospira Australia Pty Ltd，注册证号H20090521，规格为每瓶50 mg∶50 mL)75 mg／m2，静脉滴注5-氟尿嘧啶(西安海欣制药有限公司，国药准字H20050511，规格为0.25 mg)500 mg／m2，持续96 h，3周为

1个疗程。观察组给予DOS化疗方案，化疗第1天静脉滴注多西他赛(江苏恒瑞医药股份有限公司，国药准字H20020543，规格为每支0.5 mL∶20 mg)75 mg／

m2，持续1 h；奥沙利铂(四川美大康佳乐药业有限公司，国药准字H20050141，规格为每瓶100 mL∶100 mg)75 mg／m2，静脉滴注2 h；第1天至第14天口