- 期刊
Postoperative Concurrent Chemoradiotherapy for Non-Early Stage Gastric Adenocarcinoma
非早期胃腺癌術後同步施行放射線治療及化學治療
摘要
目的：研究胃腺癌開刀後，追加輔助性同步施行放射線治療及化學治療之治療結果。 材料與方法：直至2002年4月，本院始針對第二、三、四期無遠端轉移，可行根治性切除之胃腺癌病人，建議病人於接受根治性手術復原後，給予輔助同步施行放射線治療及化學治療。又至2005年4月，共31位病人接受術後輔助同步施行放射線治療及化學治療之建議，而另35位病人則只接受根治性手術。 結果：多變數分析顯示病人所選擇之治療方式及其疾病分期及外科切除術式，顯著影響存活率。在輔助同步施行放射線治療及化學治療的這一組病人，其三年存活率及局部控制率分別為61.3%和76.4%；而只接受手術的這一組病人，其三年存活率及局部控制率，則明顯較低，分別為40.0%和47.9%（log-rank p皆小於0.05）。但在輔助同步施行放射線治療及化學治療的這一組病人，有19.4%的病人有嚴重之急性腸胃道副作用。 結論：依我們過去的經驗，施行過根治性手術之第二、三、四期無遠端轉移之胃腺癌病人，若接受輔助之合併化學治療及放射治療，可能明顯改善其存活率及局部控制率。
並列摘要
Purpose: To analyze the treatment outcome of adjuvant concurrent chemoradiotherapy for patients with gastric adenocarcinoma. Material and Method: After April 2002, adjuvant concurrent chemoradiotherapy (CCRT) was suggested for our patients with gastric adenocarcinoma of stage Ⅱ, Ⅲ, and Ⅳ (MO) after gastrectomy. Until April 2005, thirty-one patients received adjuvant CCRT with median dose of 45 Gy (ranged from 14.4 to 50.4 Gy). The other thirty-five patients in this period had no other treatment after radical surgery. Results Multivariate analysis of Cox regression showed the factors of stages, treatment methods, and surgical dissection (D1 or D2) were significant prognostic factors for survival rate. By using Kaplan-Meier methods, the 3-year survival and local control rates in adjuvant CCRT group were 61.3% and 76.4%, and the 3-year survival and local control rates in operation alone group were 40% and 47.9% (significantly lower, log-rank p＜0.05). The most common severe acute toxicity in the adjuvant CCRT group was gastro-intestinal (GI) grade Ⅲ complication according to the Radiation Therapy Oncology Group for acute radiation morbidity scoring criteria. Six out of 31 patients with CCRT (19.4%) had the grade Ⅲ G1 acute side effect. Conclusion: Adjuvant CCRT after radical gastrectomy might significantly improve survival and local control in patients with gastric adenocarcinonia of stage Ⅱ, Ⅲ, and Ⅳ (MO) in our experience.
延伸閱讀
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