【作者】 赵宜良； 杨巍； 张涛； 刘勇； 刘彦擎；

【Author】 Zhao Yi-Liang Yang Wei Zhang Tao Liu Yong Liu Yan-Qing LiaoNing province tumor hospital ShenYang 110042 China

【机构】 辽宁省肿瘤医院胃外科；

【摘要】 目的:探讨胃癌锁骨上淋巴结转移(左侧)综合治疗效果。方法:12例患者病理证实胃癌左侧锁骨上淋巴结转移。治疗方案分三阶段:第一阶段新辅助化疗,奥沙利铂 100mg／m2,甲酰四氢叶酸钙200 mg／m2,5-Fu500 mg／ m2,共两个周期。第二阶段手术治疗,7例经化疗锁骨上转移淋巴结完全消失(CR),行全胃切除2例,近侧胃大部切除2 例,远端胃大部切除3例。第三阶段术后辅助化疗,7例手术患者术后辅助化疗四个周期。结果:新辅助化疗左侧锁骨上转移淋巴结完全消失(CR)7例,PR 3例,PD 2例,术后随访生存3年2例,生存2年4例,生存1年半1例。未手术者1年内死亡。结论:胃癌锁骨上淋巴结转移综合治疗效果肯定。含第三代铂类药物奥沙利铂的化疗方案是治疗晚期胃癌锁骨上淋巴结转移的良好选择之一。更多还原

【Abstract】 Objective: To discuss the effect analysis of complex treatment of gastric cancer with supra clavicular lymph node metastasis. Methods: 12 cases of gastric cancer with supra clavicular lymph node metastasis were approved by pathology. The treatment project falls into three phase. The first phase is. Oxaliplatin 100mg/m2, calcium leucovorin 200 mg/m2, 5 - Fu500 mg/m2,these cases were treated 2 cycles in all.The second phase is operation.7 CR cases were operated, 2 total gastrectomy, 2 proximal subtotal gastrectomy, 3 distal subtotal gastrectomy. The third phase is postoperative adjuvant chemotherapy.7 operative cases were treated 4 cycles in all. Results: neoadjuvant chemotherapy effection is CR 7, PR 3, PD 2. Follow up survey after operation displays surviving 3 years 2 cases, surviving 2 years 4 cases, surviving 1.5 years 1 cases. No- operation cases are death, within lyear. Conclusion: The complex treatment of gastric cancer with supra clavicular lymph node metastasis is effective affirmatively. The chemotherapy scheme with oxaliplatin which is third generation platinum drug is one of good choice of treating advanced gastric cancer with supra clavicular lymph node metastasis.更多还原