發(fā)布時(shí)間：2018-01-30 07:40

  本文關(guān)鍵詞： 進(jìn)展期胃癌 療效 毒副反應(yīng) 奧沙利鉑 氟尿嘧啶　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:受“精準(zhǔn)醫(yī)療”這種新型醫(yī)療模式的影響,進(jìn)展期胃癌患者的治療模式由之前的單純手術(shù)治療模式轉(zhuǎn)變?yōu)槟壳暗氖中g(shù)治療+術(shù)后輔助治療,強(qiáng)調(diào)了根治性手術(shù)及輔助化療的精準(zhǔn)用藥。本研究旨在通過病例回顧比較以奧沙利鉑聯(lián)合氟尿嘧啶為主的三種輔助化療對治療進(jìn)展期胃癌根治術(shù)后患者的療效和不良反應(yīng)。分析三種輔助化療方案在治療進(jìn)展期胃癌患者中的療效及安全性。方法:回顧性分析2004年4月至2009年11月間河北醫(yī)科大學(xué)第四醫(yī)院外三科收治的經(jīng)病理證實(shí)的進(jìn)展期胃癌患者634例,所有胃癌患者均行根治術(shù)治療,術(shù)后接受輔助治療6療程。634例患者分為3組,按照方案不同分成3組,其中XELOX組112例,mFLO組220例,FOLFOX4組302例。所有病例治療于2009年11月結(jié)束,均隨訪至2011年12月,隨訪時(shí)間25~80個(gè)月,中位隨訪35個(gè)月。對三組患者的無病生存時(shí)間(DFS)、總生存時(shí)間(OS)及不良反應(yīng)進(jìn)行對照研究。結(jié)果:1有104例患者在隨訪過程中失訪,530例患者有完整的隨訪資料,XELOX組、mFLO組和FOLFOX4組的中位無病生存時(shí)間分別為32.6個(gè)月、25.2個(gè)月和28.8個(gè)月,三組比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。三組的中位總生存時(shí)間分別為43.2個(gè)月、40.7個(gè)月和39.5個(gè)月,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。XELOX組的中位無病生存時(shí)間和中位總生存時(shí)間均略高于mFLO組、FOLFOX4組,但分別比較后均無統(tǒng)計(jì)學(xué)差異(P0.05)。2三組出現(xiàn)的不良反應(yīng)有兩種不同情況,三組間在血液學(xué)不良反應(yīng)上無明顯差異,在非血液學(xué)不良反應(yīng)中,XELOX組在腹瀉發(fā)生率明顯低于mFLO組和FOLFOX4組,具有統(tǒng)計(jì)學(xué)差異(P=0.010.05,P=0.0370.05),XELOX組和FOLFOX4組在外周神經(jīng)毒性發(fā)生率上明顯低于mFLO組,具有統(tǒng)計(jì)學(xué)差異(P=0.0010.05,P=0.0030.05),以上不良反應(yīng)均可耐受。結(jié)論:1在胃癌的術(shù)后輔助化療中,XELOX、mFLO、FOLFOX4三種化療方案在DFS和OS方面無明顯統(tǒng)計(jì)學(xué)差異。2結(jié)合毒副反應(yīng),XELOX方案較其他兩組治療方案應(yīng)用更方便、耐受性更好、安全性更高,值得臨床進(jìn)一步推廣和應(yīng)用。
[Abstract]:Objective: influenced by the "precise medical" the new medical mode, advanced gastric cancer patients treated by surgery alone before the treatment mode to change the mode of adjuvant therapy for surgery + patients after the present, emphasizes precise medication radical surgery and adjuvant chemotherapy. To review three cases with adjuvant chemotherapy with oxaliplatin fluorouracil based efficacy and adverse reactions of the patients after radical operation in the treatment of advanced gastric cancer. This study analyzed three adjuvant chemotherapy efficacy and safety in the treatment of patients with advanced gastric cancer. Methods: a retrospective analysis from April 2004 to November 2009 between the fourth hospital of Hebei Medical University were treated by 634 patients with advanced gastric cancer pathology confirmed, all gastric cancer patients underwent radical resection treatment, receiving adjuvant treatment 6 treatment.634 patients were divided into 3 groups after operation, according to the different schemes 鍒嗘垚3緇，

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