【摘要】 目的分析研讨挽救性放疗在局部晚期胃癌根治术后区域淋巴结复发中的作用。方法本次讨论中所研讨的78例患者均随机从我院2015年11月至2016年10月收治的胃癌根治术后区域淋巴结复发患者中筛选而出,排除有远处转移及腹膜种植转移的患者,对其进行挽救性放疗,将其治疗结果纳入对比研讨中。结果挽救性治疗状况:24例患者仅化疗,36例患者进行化疗后放疗或进行同步化疗,另外18例患者首选放疗(不加或加化疗)。经过挽救性治疗后,21例患者完全得到缓解,其中9例患者在最后随访期间无病生存,有12例患者远处转移;另外57例患者中,51例患者肿瘤进展。放疗组局部复发15例,复发率为27.78%(15/54),化疗组局部复发21例,复发率为87.50%(21/24)。两组复发率对比有统计学意义(P<0.05);患者无病生存期和总生存期:放疗组中位PFS为20个月,化疗组为6个月,两组对比有统计学意义(P<0.05);此外,先接受化疗后行放疗的OS(中位OS为36个月)比单独行化疗(中位OS为15个月)优,组间数据有统计学意义(P<0.05);急性毒性反应:放疗期间,36例患者出现急性胃肠道毒性,毒副反应为腹部不适和恶心,经对症治疗后,患者症状得到缓解,无病例出现3级以上或者其他毒副反应;挽救性化疗期间,22例患者出现骨髓抑制,4例患者出现口腔炎。经对症治疗后,有所好转。结论挽救性放疗可作为局部晚期胃癌根治术后区域淋巴结复发的有效治疗方式,可延长患者生存时间,值得临床应用。更多还原

【Abstract】 Objective To study the effect of salvage radiotherapy on regional lymph node recurrence after radical resection of locally advanced gastric cancer. Methods 78 cases of the study of this discussion patients were randomly from our hospital from November 2015 to October 2016 were gastric cancer after radical resection of regional lymph nodes in patients with recurrent selection and exclusion, distant metastasis and peritoneal metastasis of patients, the salvage radiotherapy, the treatment results into the contrast research. Results Salvage treatment:24 patients were treated with chemotherapy only,and the other one was treated with radiotherapy or concurrent chemotherapy after chemotherapy,and the other 36 patients were treated with radiotherapy(without or without chemotherapy)in the other 18 patients.After the salvage treatment, 21 patients were completely relieved, of which 9 patients had no disease at the final follow-up, and there were distant metastases in the other 12 patients. In the other 57 patients, the tumor progression was seen in 51 patients.The recurrence rate was 27.78%(15/54) in the radiotherapy group(n=15), and the recurrence rate was 87.50%(21/24) in the chemotherapy group(n=21). The recurrence rate of two groups compared with statistical significance(P<0.05); disease free survival and overall survival:Radiotherapy group the median PFS was 20 months,6 months in the chemotherapy group, there was statistical significance between the two groups(P<0.05); in addition,the first chemotherapy radiotherapy OS(median OS was 36 months) than chemotherapy alone(median OS was 15 months), the data between the two groups was statistically significant(P<0.05). Conclusion Salvage radiotherapy can be used as an effective treatment for local lymph node recurrence after radical resection of locally advanced gastric cancer.It can prolong the survival time of patients, and is worthy of clinical application and promotion.更多还原