Short-Term Curative Effect On Neoadiuvant Chemotherapy Foradenocar Cinoma Of The Esophagog Astricjunction

ObjectiveTo determine whether neoadiuvant chemotherapy shows additional clinical benefit inpatients with surgery followed by aduvant chemotherapy.MethodsWe collected90patients with adenocar cinoma of the esophagog astricjunction in ourhospital from June2005to July2009.They were randomly divided into investigate groupand comparision group.The investigate group were treated with neoadjuvantchemotherapy.The amount of chemotherapy drugs were in strict accordance with thepatients body surface area. Assess the clinical efficacy after treatment and Compare thetherapeutic efficacy and the Incidence of toxicity.We used Response Evaluation Criteria inSolid Tumorsto evaluate the cllinical efficacy. Clicinal state adopted to the AmericanCancer Joint Commitee(AJCC) stomath TNM(2010seventh edition).ConclusionThe age,gender,clinical staging of investigate group and comparision group had nostatistically significant(P＞0.05).45patients were in investigate group.Among them,34patients were males,11patients were females, the age was43-75years old with anaverage age59years.2cases were in clinical stage IB,5cases in clinical stage IIA,9cases inclinical stage IIIA.45patients were in comparison group.Among them,31patients weremales,14patients were females, the age was47-72years old with an average age59.5years.1case was in clinical stage IB,6cases in clinical stage IIA,12casesin clinical stageIIB,11cases in clinical stage IIIA,11cases in clinical stage IIIB,4cases in clinical stageIIIC.The rate of follow-up was100%and the median follow-up time was2years.Ininvestigate group,1case failed to be operated because of metastasis to liver after3cycles ofneoadjuvant chemotherapy.After chemotherapy,in investigate group,2cases were in stageIB,13cases in clinical stage IIA,15cases in clinical stage IIB,10cases in clinical stage IIIA,2cases in clinical stage IIIB,2cases in clinical stage IIIC,1case in clinical stage IV.The clinical stage was significantly reduced after chemotherapy,and the difference wasstatistically significant.(χ2=12.954，p＜0.05).In comparison group,in addition to the case ofliver metastasis,44cases were D2surgery.The resection rate of R0surgery was81.8%.Thedifference of radical resection rate had statistically significant(χ2=4.485，p＜0.05).Themaintoxic side effects included myelosuppression,gastrointestinalreactions,abnormality of hepatic and renal function,and neurotoxicity.And mostly theeffects were1-2grade,and had been alleviated after symptomatic treatment.The toxic sideeffects of ECF were safe and well tolerated,and had no effect on the surgical treatment.Theneoadjuvant chemotherapy reduced the preopertive stage,imoroved the surgical curerate,incruced the2-year survival rate.Neoadiuvant chemotherapy has the greater benefit ofpatients with adenocar cinoma of the esophagog astricjunction.