【摘要】 目的探讨Lauren分型为混合型的进展期胃癌接受术后放化疗的近期疗效和远期疗效。方法回顾性分析2014年6月至2015年6月在江南大学附属医院行D₂根治术的Lauren分型为混合型进展期胃癌患者50例,术后XELOX化疗2个周期,后同期放化疗,放疗后辅助化疗XELOX4个周期,放疗采用IMRT, DT为45Gy/25次。评价不良反应,随访患者的3年总生存率（OS）和3年无瘤生存率（DFS）。结果 50例混合型胃癌患者中位年龄为57岁（30～75岁）,男女比例1.5∶1,3年OS率为60.0%,3年的DFS率为52.0%。Cox回归单因素分析显示N分期和淋巴结阳性率是影响OS和DFS的预后因素。最常见1～2级不良反应为血液学毒性、胃肠道反应、手足口综合征,6例3级的恶心反应,3例3级的手足口综合征,1例4级白细胞减少,1例4级贫血,2例4级食欲不振。结论 Lauren分型为混合型的进展期胃癌术后放化疗疗效尚可,不良反应可耐受,安全性良好。更多还原

【Abstract】 Objective To explore the short-term and long-term effects of postoperative radiotherapy and chemotherapy for Lauren’s mixed type advanced gastric cancer. Methods From June 2014 to June 2015, 50 patients with mixed advanced gastric cancer were analyzed retrospectively. After operation, the patient received XELOX chemotherapy for 2 cycles, followed by radiotherapy and chemotherapy at the same time, followed by adjuvant chemotherapy for XELOX 4 cycles. The radiotherapy was IMRT and DT was 45 Gy/25 times. The adverse reactions were evaluated. The overall 3-year survival rate(OS) and 3-year tumor free survival rate(DFS) were evaluated. Results The median age of 50 patients with mixed gastric cancer was 57 years(30-75 years), the ratio of male to female was 1.5∶1, the 3-year OS rate was 60.0%, and the 3-year DFS rate was 52.0%. Cox regression univariate analysis showed that N stage and lymph node positive rate were the prognostic factors of OS and DFS. The most common level 1-2 adverse reactions were hematological toxicity, gastrointestinal reaction, hand foot mouth syndrome. There were 6 cases of grade 3 nausea, 3 cases of grade 3 hand foot mouth syndrome, 1 case of grade 4 leukopenia, 1 case of grade 4 anemia and 2 cases of grade 4 anorexia. Conclusion Lauren’s mixed type of advanced gastric cancer is safe and tolerable.更多还原