Du Yian, Cheng Xiangdong, Yu Pengfei, Yang Litao, Wang Bing, Huang Ling, Dong Ruizeng, Xu Zhiyuan, Zhou Yiming
Hepatogastroenterology. 2014 Jun;61(132):1159-64.
BACKGROUND/AIMS: To investigate the efficacy and safety of PCF chemotherapy combined with surgery in the treatment of late-stage gastric cancer.
From July 2008 to February 2011, 72 cases of late-stage gastric cancer that could not be treated with R0 resection were treated prospectively. Patients received 2-4 cycles of paclitaxel plus cisplatin and 5-fluorouracil (PCF regimen) chemotherapy followed by cytoreductive surgery for the primary and metastatic tumors and another 2-4 cycles of PCF chemotherapy post-operatively. The treatment completion rate, patient tolerance and overall survival time were analyzed.
There was one perioperative death. The overall response rate (complete and partial response) was 72.2%. Fifty patients (69.4%) completed chemotherapy and surgical resection as planned and 42 (58.3%) cases had R0 resection. The median survival time was 23.5 months (95% CI: 15.8-31.2 months). One-year and 2-year survival rates were 67.0% and 47.0%. The survival time of patients with surgical resection was much longer than that of the non-surgery group (30.2 vs. 8.9 months) (P < 0.01). The survival time of local advanced group was 30.3 months, and was significantly longer than 17.6 months of the distant metastasis group (P < 0.01); however, it had no significant difference compared to 28.2 months of the distant metastasis group with R0 resection.
PCF chemotherapy combined with surgical resection were safe and effective, and can make survival benefits for some late-stage gastric cancer patients.
背景/目的:探讨PCF化疗联合手术治疗晚期胃癌的疗效及安全性。
2008年7月至2011年2月,对72例无法行R0切除的晚期胃癌患者进行前瞻性治疗。患者接受2 - 4周期的紫杉醇联合顺铂及5-氟尿嘧啶(PCF方案)化疗,随后对原发性和转移性肿瘤进行减瘤手术,术后再进行2 - 4周期的PCF化疗。分析治疗完成率、患者耐受性及总生存时间。
围手术期死亡1例。总缓解率(完全缓解和部分缓解)为72.2%。50例(69.4%)患者按计划完成化疗及手术切除,42例(58.3%)患者实现R0切除。中位生存时间为23.5个月(95%可信区间:15.8 - 31.2个月)。1年和2年生存率分别为67.0%和47.0%。接受手术切除患者的生存时间明显长于未手术组(30.2对8.9个月)(P < 0.01)。局部晚期组的生存时间为30.3个月,明显长于远处转移组的17.6个月(P < 0.01);然而与远处转移且行R0切除组的28.2个月相比无显著差异。
PCF化疗联合手术切除安全有效,可为部分晚期胃癌患者带来生存获益。