中国普外基础与临床杂志

中国普外基础与临床杂志

腹腔镜围术期后 mFOLFOX6 联合阿司匹林治疗进展期胃癌的临床观察

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目的 评价腹腔镜围术期后 mFOLFOX6 联合阿司匹林治疗进展期胃癌的临床疗效。 方法 前瞻性纳入了笔者所在医院 2011 年 1 月至 2014 年 1 月期间收治的 107 例符合纳入标准的进展期胃癌患者,采用单盲队列研究,分为 mFOLFOX6 组(50 例)和 mFOLFOX6+阿司匹林组(57 例),mFOLFOX6+阿司匹林组患者在腹腔镜围术期后给予 mFOLFOX6 联合阿司匹林治疗,mFOLFOX6 组患者腹腔镜围术期后单用 mFOLFOX6 方案化疗,比较 2 组患者的肿瘤复发率或转移率、毒副反应、中位生存期及 3 年总生存率和 3 年无病生存率。 结果 ① 2 组患者在性别、年龄、病理类型、术后分期等基线资料比较差异均无统计学意义(P>0.05)。② mFOLFOX6+阿司匹林组和 mFOLFOX6 组患者的毒副反应如白细胞减少、粒细胞减少、血小板减少、血红蛋白减少、恶心、呕吐及周围神经病变发生率比较差异均无统计学意义(P>0.05)。③ 2 组患者的随访时间 4~45 个月,中位随访时间 3.5 年;mFOLFOX6+阿司匹林组和 mFOLFOX6 组患者的随访率分别为 94.7%(54/57)和 92.0%(46/50);与 mFOLFOX6 组比较,mFOLFOX6+阿司匹林组患者的中位生存期明显延长(P=0.043),3 年总生存率和 3 年无病生存率明显提高(P=0.042、P=0.021),3 年累积总生存和 3 年累积无病生存情况均明显更好(P=0.015、P=0.037),疾病进展率更低(P=0.032)。 结论 本研究有限病例的研究结果提示,腹腔镜围术期后采用 mFOLFOX6+阿司匹林治疗进展期胃癌的临床效果显著,可减缓胃癌患者的疾病进展,提高生存率而不增加毒副作用。

Objective To evaluate clinical efficacy of mFOLFOX6 combined with aspirin in treatment of advanced gastric cancer following perioperative period of laparoscopic distal subtotal gastrectomy. Methods One hundred and seven patients with advanced gastric cancer were assigned to observation group (57 cases) and control group (50 cases). The patients in the observation group received the mFOLFOX6 chemotherapy and regular intake of aspirin (100 mg/d) and the control group received the mFOLFOX6 chemotherapy alone. The recurrence or metastasis rate, rate of disease progress, toxicity, median survival time, and 3-year survival rate were compared between the observation group and the control group. Results ① There were no significant differences in the gender, age, pathological type, and so on between the observation group and the control group (P>0.05). ② The rates of toxicity such as the white blood cell reduction, granulocyte reduction, thrombocytopenia had no significant differences in these two groups (P>0.05). ③ The follow-up time was 4–45 months with an average 3.5 years, the rate of disease progress was lower (P=0.032), the median survival time was longer (P=0.043), the cumulative 3-year overall survival (P=0.015) and the cumulative 3-year disease-free survival (P=0.037) were better in the observation group as compared with the control group. Conclusion Preliminary results in this study show that mFOLFOX6 regimen combined with low-dose aspirin could significantly improve efficacy of advanced gastric cancer following perioperative period of laparoscopic distal subtotal gastrectomy, reduce rate of disease progress, and improve survival rate without increasing side effects.

关键词: 进展期胃癌; 腹腔镜远端胃大部切除术; 阿司匹林; mFOLFOX6 化疗方案; 生存

Key words: advanced gastric cancer; laparoscopic distal subtotal gastrectomy; aspirin; mFOLFOX6 regimen; survival

引用本文: 宋英杰, 全昌银, 曹胜华, 章园, 邵新宏, 王朝晖, 樊涛. 腹腔镜围术期后 mFOLFOX6 联合阿司匹林治疗进展期胃癌的临床观察. 中国普外基础与临床杂志, 2018, 25(2): 166-170. doi: 10.7507/1007-9424.201708011 复制

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