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目的探讨新辅助治疗在进展期胃癌中的临床应用效果及对预后的影响。方法选取86例进展期胃癌患者作为研究对象,将其随机分为观察组和对照组,每组43例。观察组患者于术前接受新辅助化疗并于术后接受辅助化疗,对照组患者只在术后接受辅助化疗。对观察组的术前化疗疗效和2组患者的毒性反应、根治性切除率、术后1年复发率和术后2年生存率进行观察和分析。结果观察组患者经过新辅助化疗治疗后,临床有效率达到74.4%,有37例患者(86.0%)进行了胃癌根治性手术,而对照组中有28例患者(65.1%)进行了胃癌根治性手术,观察组行根治性手术的患者比例显著高于对照组(P<0.05);观察组行远端胃大部切除术的比例显著高于对照组(P<0.05);观察组和对照组患者消化道毒性反应的发生率分别为76.7%和72.1%,差异无统计学意义(P>0.05);2组患者出现骨髓抑制反应的比例分别为9.3%和7.0%,差异无统计学意义(P>0.05),给予对症治疗后均能顺利完成化疗,未发生严重并发症和死亡病例;观察组和对照组患者的术后1年肿瘤复发率分别为11.6%和32.6%,差异有统计学意义(P<0.05),且观察组患者的肿瘤复发时间显著长于对照组(P<0.05);2组患者的2年生存率分别为90.7%和72.1%,差异有统计学意义(P<0.05)。结论新辅助治疗可有效控制进展期胃癌患者病情的进展,有利于肿瘤的切除,并可显著降低复发率,延缓复发时间并提高生存率,对改善患者预后有积极的作用,且安全性和患者耐受性较高,值得临床推广应用。
Objective To explore the clinical effect of neoadjuvant therapy in advanced gastric cancer and its effect on prognosis. Methods Eighty-six patients with advanced gastric cancer were selected as study subjects. They were randomly divided into observation group and control group, 43 cases in each group. The patients in the observation group received neoadjuvant chemotherapy before surgery and received adjuvant chemotherapy after surgery. Patients in the control group received adjuvant chemotherapy only after surgery. The preoperative chemotherapy efficacy in the observation group and the toxicity, radical resection rate, postoperative one-year recurrence rate, and postoperative two-year survival rate of the two groups were observed and analyzed. Results After treatment with neoadjuvant chemotherapy in the observation group, the clinical effective rate was 74.4%. 37 patients (86.0%) underwent radical surgery for gastric cancer, while 28 patients (65.1%) in the control group underwent radical gastrectomy. The proportion of patients undergoing radical surgery in the observation group was significantly higher than that in the control group (P<0.05); the proportion of distal gastrectomy in the observation group was significantly higher than that in the control group (P<0.05); the observation group and the control group The incidence of gastrointestinal toxicity in patients was 76.7% and 72.1%, respectively, with no statistically significant difference (P>0.05). The proportion of patients with bone marrow suppression in the two groups was 9.3% and 7.0%, respectively, and the difference was not statistically significant ( P>0.05). All the patients were successfully treated with chemotherapy after symptomatic treatment. No serious complications and deaths occurred. The recurrence rates of the patients in the observation group and the control group at one year were 11.6% and 32.6%, respectively. The difference was statistically significant. Significance (P<0.05), and the recurrence time of the patients in the observation group was significantly longer than that of the control group (P<0.05); the two-year survival rates of the two groups were 90.7% and 72.1%, respectively, and the difference was statistically significant (P<0.05). ). Conclusions The neoadjuvant therapy can effectively control the progression of patients with advanced gastric cancer, which is beneficial to the resection of tumors, and can significantly reduce the recurrence rate, delay the recurrence time and improve the survival rate. It has a positive effect on improving the prognosis of patients, and safety and patient Tolerance is high, worthy of clinical application.