Xie Jian, Liang Ning, Qiao Lili, Su Lei, Li Kai, Luo Hui, Zhang Jingxin, Zhang Jiandong
Department of Radiation Oncology, Qianfoshan Hospital Affiliated to Shandong University, Jinan, Shandong Province - China.
Tumori. 2015 Jul-Aug;101(4):433-9. doi: 10.5301/tj.5000336. Epub 2015 May 16.
This study aimed to assess the efficacy of concurrent chemoradiotherapy (CCRT) with docetaxel and capecitabine versus docetaxel and capecitabine chemotherapy for gastric cancer patients with postoperative locoregional recurrence.
From 2008 to 2011, 81 patients with locoregional recurrence after curative resection of gastric cancer were enrolled. Thirty-nine (CCRT group) received involved-field radiotherapy with oral capecitabine (twice daily, 5 days/week) and intravenous infusion of docetaxel (once weekly). The remaining 42 patients (chemotherapy group) were treated with oral capecitabine (twice daily, days 1-14) followed by intravenous infusion of docetaxel (days 1 and 8). The overall response rate, overall symptom control rate, toxicity or adverse reactions, and overall survival (OS) were compared.
The overall response rate (CR+PR) was significantly higher in the CCRT group (79.5%) than the chemotherapy group (54.8%). In CCRT individuals, the control rates for bleeding, pain, and dysphagia/obstruction were 87.5%, 75%, and 71.4%, respectively, versus 63.2%, 50%, and 28.6% in the chemotherapy group. CCRT patients had a better symptom control rate than the chemotherapy group (52.5% vs. 80%). Adverse reactions were nonsignificantly more severe in CCRT patients. Finally, median OS was longer in the CCRT vs. chemotherapy group (14.2 vs. 6.4 months).
Involved-field radiotherapy with docetaxel and capecitabine was effective and well tolerated. These findings provide further insight into the role of CCRT in gastric cancer. However, this was not a randomized controlled study and the number of patients was relatively small, suggesting that cautious interpretation of cumulative estimates is warranted.
本研究旨在评估多西他赛联合卡培他滨同步放化疗（CCRT）与多西他赛联合卡培他滨单纯化疗对胃癌术后局部区域复发患者的疗效。
2008年至2011年，纳入81例胃癌根治性切除术后局部区域复发的患者。39例（CCRT组）接受累及野放疗，同时口服卡培他滨（每日2次，每周5天）和静脉输注多西他赛（每周1次）。其余42例患者（化疗组）接受口服卡培他滨（每日2次，第1 - 14天），随后静脉输注多西他赛（第1天和第8天）。比较两组的总缓解率、总体症状控制率、毒性或不良反应以及总生存期（OS）。
CCRT组的总缓解率（CR + PR）显著高于化疗组（79.5%对54.8%）。在CCRT组中，出血、疼痛和吞咽困难/梗阻的控制率分别为87.5%、75%和71.4%，而化疗组分别为63.2%、50%和28.6%。CCRT组患者的症状控制率优于化疗组（52.5%对80%）。CCRT组患者的不良反应严重程度无显著增加。最后，CCRT组的中位OS长于化疗组（14.2个月对6.4个月）。
多西他赛联合卡培他滨累及野放疗有效且耐受性良好。这些发现为CCRT在胃癌中的作用提供了进一步的见解。然而，这并非一项随机对照研究，且患者数量相对较少，提示对累积估计值应谨慎解读。
