目的：观察奥沙利铂联合卡培他滨方案新辅助化疗治疗进展期胃癌患者的临床疗效、毒副作用及生存状况。方法回顾性分析2011年7月—2012年9月该医院收治的65例局部进展期可切除胃腺癌患者的临床资料。其中33例患者（实验组）完成新辅助化疗后接受开放手术治疗，32例患者（对照组）入院后直接行手术，分析比较两组患者的根治效果、术后并发症情况及生存情况等。结果实验组患者R0切除32例、R1切除1例，对照组患者R0切除24例、R1切除8例，两组比较，差异有统计学意义（χ2＝4．861，P＜0．05）；阳性淋巴结检出数目分别为（4．55±1．48）枚和（6．38±2．27）枚（t＝－3．838，P＜0．05）；淋巴结清扫数目分别为（21．24±2．67）枚和（20．19±2．71）枚及术后并发症发生数分别为3例和3例，两组差异均无统计学意义（P＞0．05）。实验组平均术中失血量（434．29±86．64）mL，对照组为（190．97±47．91）mL，差异有统计学意义（P＜0．05）。实验组患者的中位总生存时间为23．5个月，对照组为17．7个月（P＝0．138）。结论奥沙利铂联合卡培他滨新辅助化疗化疗毒副作用可耐受，可提高进展期胃癌R0切除率，降低淋巴结转移率，延长患者的生存时间。%Objective To evaluate the efficacy and toxicity of combination therapy of oxaliplatin in combination with capecitabine regi-men in patients with advanced gastric cancer.Methods The clinical data of 65 patients with advanced gastric cancer(stage IIb and II-Ic)admitted to the First Affiliated Hospital of Anhui Medical University from July 201 1 to September 2012 were retrospectively ana-lyzed.All the patients were divided into the neoadjuvant chemotherapy group(33 cases)and the surgery alone group(32 cases).The ef-ficacy of radical resection,postoperative complication rate,and overall survival of the 2 groups were compared.Results The numbers of patients who received R0 and R1 resection in the neoadjuvant chemotherapy group were 32 and 1 ,which were significantly different from 24 and 8 in the surgery alone group(χ2 =4.861,P<0.05).The number of lymph node metastasis in the treatment group(4.55 ± 1.48)was significantly lower than that in the control arm(6.38 ±2.27,t=-3.838,P<0.05).There was no significant difference in the number of postoperative complication cases(3 cases vs 3 cases)and the number of lymph node dissection(21.24 ±2.67 vs 20.19 ± 2.71)between the two groups(P >0.05).The average volume of peri-operative bleeding in the treatment group(434.29 ±86.64)mL was significantly higher than that in the control arm[(190.97 ±47.91)mL,P<0.05].The survival analysis indicated that the median overall survival was longer in the neoadjuvant chemotherapy group(23.5 months)in comparison with this in the surgery along group (17.7 months),but no significant difference was found(P=0.138).Conclusions The combined neoadjuvant chemotherapy regimen of oxaliplatin and capecitabine can be effective.Patients tolerance and compliance are satisfying.It can improve the R0 resection rate in patients with advanced gastric cancer,and reduce lymph node metastasis and improve survival.
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