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目的 探讨胃癌术后放化疗的临床意义、治疗方法和毒副反应。方法 将 1995～ 1998年 10 6例晚期胃癌 (ⅢB～Ⅳ期 )根治术后的病人随机分为 :常规放射治疗组 (单放组 ) 5 3例 ,术后高危区域常规外照射总量DT5 4Gy ,每次 1 8Gy ,每周 5次 ,均采用 8MVX线照射 ;综合组 5 3例 ,外照射同常规放射治疗组 ,放射治疗当日及外照射达DT4 0Gy时 ,同时合并化疗。化疗方案 :5 氟尿嘧啶 (5 FU) 5 0 0mg/d ,5d ;亚叶酸钙 (CF) 2 0 0mg/d ,5d。 结果 全部病人随访 5年以上 ,随访率 96 2 %。局控率综合组和单放组分别为 5 8 5 %和 4 1 5 % (P >0 0 5 ) ;综合组和单放组的 1、3、5年生存率分别为 :81 1%、5 0 9%、34 0 %和 6 9 8%、35 9%、2 0 8%。 3、5年生存率差异有显著性 (P <0 0 5 )。综合组的毒副反应高于单放组。结论 晚期胃癌 (ⅢB～Ⅳ期 )根治术后放疗合并 5 FU加CF化疗优于单纯术后放疗 ,是晚期胃癌术后治疗的一种有效方法
Objective To investigate the clinical significance of radiotherapy and chemotherapy after treatment of gastric cancer, treatment and toxicity. Methods A total of 106 patients with advanced gastric cancer (stage ⅢB-Ⅳ) from 1995 to 1998 were randomly divided into three groups: conventional radiotherapy group (single radiotherapy group), 53 cases of conventional radiotherapy after high-risk area total DT5 4Gy , Each of 8Gy, 5 times a week, were used 8MVX line irradiation; integrated group of 53 cases of external radiation with conventional radiotherapy group, radiotherapy day and external radiotherapy DT4 0Gy, combined with chemotherapy. Chemotherapy regimen: 5-fluorouracil (5 FU) 500 mg / d for 5 days; leucovorin (CF) 200 mg / d for 5 days. Results All patients were followed up for more than 5 years with a follow-up rate of 96 2%. The rate of 1,3,5-year and 1,3-year survival rates in the combination group and the radiotherapy alone group were 81.5% and 45.1% respectively (P> 0.05) 5 0 9%, 34 0% and 69 8%, 35 9% and 20 0% respectively. The 3-year and 5-year survival rates were significantly different (P <0.05). Toxicity of the combined group was higher than that of the single group. Conclusions Radiotherapy combined with 5 FU plus CF chemotherapy is superior to postoperative radiotherapy in the treatment of advanced gastric cancer (stage ⅢB-Ⅳ), which is an effective method for postoperative treatment of advanced gastric cancer