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新辅助放化疗与新辅助化疗对进展期胃癌患者并发症及复发的临床疗效

Clinical effects of neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy on complications and recurrence in patients with advanced gastric cancer.

作者信息

Wang Rui, Li Meng, Zheng Yanjie, Zhang Wenbo, Song Ji, Yang Fang

机构信息

Rui Wang. Department of Chemoradiotherapy Center, Chengde Central Hospital, Chengde 067000, Hebei, China.

Meng Li. Department of Chemoradiotherapy Center, Chengde Central Hospital, Chengde 067000, Hebei, China.

出版信息

Pak J Med Sci. 2024 Aug;40(7):1556-1560. doi: 10.12669/pjms.40.7.9052.

Abstract

OBJECTIVE

To compare the clinical effects of neoadjuvant chemoradiotherapy (NCRT) and neoadjuvant chemotherapy (NCT) on complications and recurrence in patients with advanced gastric cancer (AGC).

METHOD

This was a retrospective study. A total of 83 patients with AGC admitted to Chengde Central Hospital between Jan. 2019 and Jun. 2021 were selected and divided into the observation group(n=41) and the control group(n=42) using a random number table. Patients in the control group received XELOX chemotherapy, and those in the observation group received intensity-modulated radiotherapy (IMRT) with concurrent XELOX chemotherapy. Compared efficacy, pathological complete response rate (pCR), R0 resection rate, adverse reactions, and quality of life (QOL) before and after treatment between the two groups.

RESULTS

The efficacy, pCR, and R0 resection rate of the observation group were significantly increased compared with those of the control group. Comparison of complications showed the number of patients experiencing gastrointestinal (GI) reactions, increased BUN, increased GPT, alopecia, and pigmentation in the observation group was decreased compared with that in the control group, with no statistically significant differences(p>0.05), and the number of patients experiencing myelosuppression was statistically significant between the two groups(p<0.05). There were no significant differences in sub-scores of physical, role, emotional, cognitive, and social functions and the overall score of QOL between the two groups(p>0.05) before treatment.

CONCLUSION

NCRT is safer and more effective in patients with AGC compared with NCT, and can significantly improve the QOL of patients. It can be widely used in clinical practice.

摘要

目的

比较新辅助放化疗(NCRT)与新辅助化疗(NCT)对晚期胃癌(AGC)患者并发症及复发的临床疗效。

方法

本研究为回顾性研究。选取2019年1月至2021年6月在承德市中心医院收治的83例AGC患者,采用随机数字表法分为观察组(n = 41)和对照组(n = 42)。对照组患者接受XELOX化疗,观察组患者接受调强放疗(IMRT)同步XELOX化疗。比较两组治疗前后的疗效、病理完全缓解率(pCR)、R0切除率、不良反应及生活质量(QOL)。

结果

观察组的疗效、pCR及R0切除率均较对照组显著提高。并发症比较显示,观察组出现胃肠道(GI)反应、血尿素氮升高、谷丙转氨酶升高、脱发及色素沉着的患者数量较对照组减少,差异无统计学意义(p>0.05),两组出现骨髓抑制的患者数量差异有统计学意义(p<0.05)。治疗前两组在身体、角色、情感、认知及社会功能子评分和QOL总分方面差异无统计学意义(p>0.05)。

结论

与NCT相比,NCRT对AGC患者更安全有效,可显著提高患者的QOL。可在临床实践中广泛应用。

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