- 期刊
Postoperative Concurrent Chemotherapy and Radiotherapy for Resectable Locally Advanced Gastric Cancer Patients－A Preliminary Report
對局部廣泛性胃癌進行術後合併化療及放療之輔助治療初步結果報告
摘要
目的：於1993年9月至1995年12月間，13位胃癌高危險群病人於辜公亮基金會孫逸仙醫院接受手術後合併化療及放療之輔助治療。本研究目的在評估於局部廣泛性胃癌病人進行術後合併化療及放療輔助治療之可行性。 材料與方法：放射治療於手術後4至6週進行，於4至5周間投予胃部及上腹淋巴引流區3440至4320 cGy 放射治療。每位病人皆有電腦斷層治療計畫及特製鉛塊，化學治療乃同時進行，處方為 5-FU為主每月或每週連續式給予。 結果：四位病人發生3級嘔吐及惡心，其中一人於3440 cGy 時提前結束治療，全部病人平均追蹤20個月(11至48個月)，沒有病人發生單獨性局部復發，僅有一位病人於殘留胃局部復發，但同時合併腹腔復發，有三位病人發生遠端轉移。 結論：在局部廣泛性胃癌病人進行術後合併化療及放療輔助治療，其急性期副作用是可接受的，短期之疾病控制及存活率與其他類似研究結果相同，合併化療及放療最恰當的處方與劑量，仍須進一步研究。
並列摘要
Purpose: To evaluate the feasibility of postoperative adjuvant concurrent chemotherapy and radiotherapy for locally advanced gastric cancer patients Materials and Methods: From September 1993 to December 1995, 13 patients who had locally advanced gastric cancer were treated with postoperative concurrent chemotherapy and radiotherapy (CCRT) at the Koo Foundation Sun Yat-Sen Cancer Center. Radiotherapy was given in the range of 3440 cGy to 4320 cGy in 4 to 5 weeks to the gastric bed and upper abdominal nodal draining regions beginning 4 to 6 weeks after surgery. All patients had computerized tomography treatment planning and customized shaping blocks. 5-Fluorouraoil based chemotherapy with either monthly or weekly continuous infusion were prescribed concomitantly. Results: Four patients developed grade 3 nausea and vomiting. One of them discontinued the CCRT earlier after the dose of 3440 cGy. At the median follow up interval of 20 months (ranged from 11 to 48 months), 10 patients were free of disease. Three patients developed recurrence. Conclusion: Our preliminary results suggest that the acute toxicity were moderate for patients with locally advanced gastric cancer who underwent postoperative CCRT using 5-FU based chemotherapy and radiotherapy up to 4000 cGy in standard fractionation. The short term disease control and survival are promising as compared with those reported by other institutions with adjuvant treatment in resected gastric patients. We suggest gastric cancer patients with T3, 4 or N1, 2 disease should be enrolled into clinical trial of adjuvant therapy postoperatively. The most appropriate radiation dosage and chemotherapy regimen needs further investigation.
延伸閱讀
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