伊立替康新辅助化疗在进展期胃癌的临床意义(1)
摘 要：目的 探索以伊立替康为主导的化疗方案对进展期胃癌新辅助化疗的可行性及安全性。方法 选择我院2008年6月～2017年10月收治的进展期胃癌患者73例，术前给予伊立替康、亚叶酸钙、5-氟尿嘧啶联合化疗两个周期后手术。记录患者化疗的有效率及毒副反应。结果 患者的毒副反应主要表现在血液系统及胃肠管系统，泌尿系统、心血管系统及神经系统未见明显不良反应。有1例因较为严重的骨髓抑制而提前结束化疗，其余均顺利完成。参照实体瘤疗效评估标准(RECIST)，化疗有效率为78.13%，无效率为21.88%。结论 胃癌患者对伊立替康联合亚叶酸钙、5-氟尿嘧啶的新辅助化疗方案有较好的耐受性，且该方法有较好的疗效。
关键词：进展期胃癌;新辅助化疗;伊立替康;亚叶酸钙;5-氟尿嘧啶
中图分类号：R735.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.050
, 百拇医药
文章编号：1006-1959(2018)24-0164-03
Abstract：Objective To explore the feasibility and safety of irinotecan-based chemotherapy regimen for neoadjuvant chemotherapy for advanced gastric carcinoma.Methods 73 patients with advanced gastric carcinoma admitted to our hospital from June 2008 to October 2017 were enrolled. Two cycles after irinotecan， leucovorin and 5-fluorouracil were given before surgery. The chemotherapy efficiency and toxicity of the patients were observed. side effects.Results The patient's toxic and side effects were mainly manifested in the blood system and gastrointestinal system. No obvious adverse reactions were found in the urinary system， cardiovascular system and nervous system.1 patient had early termination of chemotherapy due to more severe myelosuppression， and the rest were successfully completed. According to the solid tumor evaluation criteria (RECIST)， the effective rate of chemotherapy was 78.13%， and the ineffective rate was 21.88%.Conclusion Gastric carcinoma patients have better tolerance to irinotecan combined with calcium leucovorin and 5-fluorouracil， and this method has a good effect.
, 百拇医药
Key words：Advanced gastric carcinoma;Neoadjuvant chemotherapy;Irinotecan;Leucovorin;5-fluorouracil
胃癌(gastric carcinoma)是最常見的消化道肿瘤，近年来，其发病率遂渐上升，且有年轻化的趋势[1]。胃癌恶性程度高，治疗效果差，年生存率仅为30%～50%[2]。外科手术仍是最有效的治疗手段，但往往手术时已有亚转移灶存在，术后易复发、转移率较高，总体预后差[3]。目前，国内外学者已基本认同新辅化疗能使胃癌患者获益，但化疗方案众多，其疗效亦有差别。我科自2008年开始开展新辅助化疗治疗手术治疗胃癌患者，取得了较好的疗效，现报道如下。
1 资料与方法
1.1一般资料 选择中南大学湘雅海口医院胃肠外科2008年6月～2017年10月收治的进展期胃癌患者73例。纳入标准：①经病理确诊为胃癌患者，经胃镜或CT检查，临床分期≥Ⅲb期，手术切除困难。②未任其他任何抗肿瘤治疗的初治患者;③一般情况可，肝肾功能、出凝血功能、白细胞、中性粒细胞正常者;④患者及家属同意并签署知情同意书。排除标准：①不耐受化疗者;②中途退出者。64例患者按治疗计划完成治疗，其中男性29例，女性35例，年龄31～77岁，平均年龄(56.92±5.41)岁。其中中分化腺癌19例，低分化腺癌35例，印戒细胞癌10例。
1.2化疗方案 伊立替康180 mg/(m2·d)静脉滴注，第1天;亚叶酸钙200 mg/(m2·d)，静脉滴注2 h;5-氟尿嘧啶400 mg/(m2·d)，静脉注射，随后5-氟尿嘧啶600 mg/(m2·d)，静脉泵入，维持22 h，第1天，第2天;间隔2周行第2个周期，化疗结束后2周手术治疗。, 百拇医药(王绥能 梁贤文 孙光 侯开庆 彭勃)
关键词：进展期胃癌;新辅助化疗;伊立替康;亚叶酸钙;5-氟尿嘧啶
中图分类号：R735.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.050
, 百拇医药
文章编号：1006-1959(2018)24-0164-03
Abstract：Objective To explore the feasibility and safety of irinotecan-based chemotherapy regimen for neoadjuvant chemotherapy for advanced gastric carcinoma.Methods 73 patients with advanced gastric carcinoma admitted to our hospital from June 2008 to October 2017 were enrolled. Two cycles after irinotecan， leucovorin and 5-fluorouracil were given before surgery. The chemotherapy efficiency and toxicity of the patients were observed. side effects.Results The patient's toxic and side effects were mainly manifested in the blood system and gastrointestinal system. No obvious adverse reactions were found in the urinary system， cardiovascular system and nervous system.1 patient had early termination of chemotherapy due to more severe myelosuppression， and the rest were successfully completed. According to the solid tumor evaluation criteria (RECIST)， the effective rate of chemotherapy was 78.13%， and the ineffective rate was 21.88%.Conclusion Gastric carcinoma patients have better tolerance to irinotecan combined with calcium leucovorin and 5-fluorouracil， and this method has a good effect.
, 百拇医药
Key words：Advanced gastric carcinoma;Neoadjuvant chemotherapy;Irinotecan;Leucovorin;5-fluorouracil
胃癌(gastric carcinoma)是最常見的消化道肿瘤，近年来，其发病率遂渐上升，且有年轻化的趋势[1]。胃癌恶性程度高，治疗效果差，年生存率仅为30%～50%[2]。外科手术仍是最有效的治疗手段，但往往手术时已有亚转移灶存在，术后易复发、转移率较高，总体预后差[3]。目前，国内外学者已基本认同新辅化疗能使胃癌患者获益，但化疗方案众多，其疗效亦有差别。我科自2008年开始开展新辅助化疗治疗手术治疗胃癌患者，取得了较好的疗效，现报道如下。
1 资料与方法
1.1一般资料 选择中南大学湘雅海口医院胃肠外科2008年6月～2017年10月收治的进展期胃癌患者73例。纳入标准：①经病理确诊为胃癌患者，经胃镜或CT检查，临床分期≥Ⅲb期，手术切除困难。②未任其他任何抗肿瘤治疗的初治患者;③一般情况可，肝肾功能、出凝血功能、白细胞、中性粒细胞正常者;④患者及家属同意并签署知情同意书。排除标准：①不耐受化疗者;②中途退出者。64例患者按治疗计划完成治疗，其中男性29例，女性35例，年龄31～77岁，平均年龄(56.92±5.41)岁。其中中分化腺癌19例，低分化腺癌35例，印戒细胞癌10例。
1.2化疗方案 伊立替康180 mg/(m2·d)静脉滴注，第1天;亚叶酸钙200 mg/(m2·d)，静脉滴注2 h;5-氟尿嘧啶400 mg/(m2·d)，静脉注射，随后5-氟尿嘧啶600 mg/(m2·d)，静脉泵入，维持22 h，第1天，第2天;间隔2周行第2个周期，化疗结束后2周手术治疗。, 百拇医药(王绥能 梁贤文 孙光 侯开庆 彭勃)