摘要目的 探讨进展期胃癌应用替吉奥胶囊联合注射用奥沙利铂(SOX方案)新辅助化疗的有效性和安全性.方法 回顾性分析解放军总医院普通外科2009年11月至2010年9月收治66例符合入组条件的进展期胃癌患者临床病例资料.32例患者予以术前SOX方案化疗(新辅助化疗组).SOX方案具体为:替吉奥胶囊80 mg·(m2)-1·d-1,第1～14天,注射用奥沙利铂130 mg/m2,第1天;3周重复.每2个治疗周期后进行化疗有效性和安全性评估.其余34例患者直接行外科手术(对照组).统计所有手术患者R0切除率和D2淋巴结清扫率.结果新辅助化疗组化疗有效率为68.8%,疾病控制率为93.8%;3～4级不良反应主要为呕吐(12.5%)、肝功能异常(9.4%)、贫血(6.3%)、中性粒细胞减少(6.3%)和食欲减退(6.3%);化疗后进行外科手术,其中25例(78.1%)行胃癌D2根治术,R0切除率为81.3%.对照组中,行D2根治术23例(67.6%),与新辅助化疗组比较,差异有统计学意义(P=0.028);R0切除率为73.5%,与新辅助化疗组比较,差异亦有统计学意义(P=0.040).结论 进展期胃癌应用SOX新辅助化疗具有较高的有效性,而不良反应率较低,能够提高D2根治率和R0切除率.

abstractsObjective To investigate the efficacy and safety of S-1 combined with oxaliplatin (SOX regimen) as neoadjuvant chemotherapy for advanced gastric cancer. Methods From November 2009 to September 2010, 66 patients with advanced gastric cancer were enrolled in this study. Thirtytwo patients were given preoperative chemotherapy using SOX regimen. S-1 was administered orally The treatment was repeated every 3 weeks. The efficacy and safety were assessed every 2 cycles of chemotherapy. The other 34 patients were in control group. R0 resection rate and D2 lymph nodes dissection rate were analyzed for all surgical patients. Results The overall response rate of neoadjuvant chemotherapy was 68.8% and disease control rate was 93.8%. Grade 3/4 hematological toxicities were liver dysfunction (9.4%), anemia (6.3%) and neutropenia (6.3%), and non-hematological toxicities included vomiting (12.5%) and anorexia (5.7%). Thirty-two patients after neoadjuvant chemotherapy underwent surgical resection, of whom 25 patients (78.1%) received D2 lymph nodes dissection and the R0 resection rate was 81.3%, higher than those in control group (D2 lymph nodes dissection rate:67.6% ,P=0.028; R0 resection rate:73.5% ,P=0.040). Conclusion SOX regimen as neoadjuvant chemotherapy is associated with high efficacy, acceptable adverse effect, and increased rate of D2lymph nodes dissection and R0 resection.