| Backgrand: Gastric cancer in the digestive tract malignant tumor ofthe disease first, early gastric carcinoma is difficult to discovery, whenthem went to see a doctor that the vast majority of patients havedeveloped advanced gastric carcinoma in China.Surgery is the mainmethod for the treatment of gastric cancer. At present, The second leg ofgastric cancer radical lymph node cleaning (D2Radical resection) hasbecome the standard operation for gastric cancer surgery, however, theextensive and multi-visceral resection gastric cancer radical resectionremained controversial.These patients who have been seriouslocal metastasis and distant metastasis can not have an operation.Neoadjuvant chemotherapy (preoperative chemotherapy) will become theimportant method for treatment of advanced gastric cancer. But itsindications and side effects remain to be further discussedObjective: To explore the value of neoadjuvant chemotherapy forgastric cancer clinical.Method: Retrospective analysis12patients with gastric cancer fromFebruary2012to2014April. All of the patients were diagnosed withstomach cancer by pathological biopsy in the group. They were diagnosedwith advanced gastric cancer by gastroscope, abdominal ultrasound, CT.Neoadjuvant chemotherapy regimens:Oxaliplatin plus Tegafur GimeracilOteracil Potassium Capsule (SOX regimens),two or three cycles ofchemotherapy in law, after2weeks, examined gastroscope, abdominal ultrasonography, CT again, comparative assessment after surgery.Result:12patients, complete remission (CR)0case (0.0%), partialremission (PR)8cases (66.7%), stable disease (SD)2cases (16.7%),progressive disease (PD)2cases (16.7%), response rate (CR+PR)66.7%.Radical resection4cases(33.3%),Palliative resection2case(16.7%),Exploratory surgery2cases (16.7%). The doctor evaluated thatthe rest4cases (33.3%) should not be surgery after chemotherapy.Primary focal narrowed considerably in5cases (71.4%), but the basic nochange in2cases(28.5%),primary focal expand in0. Lymph node toreduce or disappear8cases, with pancreas boundaries clear1case(12.5%). Ascites disappeared in2cases (100%).Liver metastasesdisappear1cases (20%), hepatic metastases narrow3cases (60%),metastases to expand1(20%) cases.12cases had different degree of thedigestive tract symptoms.9cases need granulocyte stimulating factorsupport treatment. Moderately differentiated adenocarcinoma4casesachieved the PR after chemotherapy. Poorly differentiated adenocar-cinoma of7cases, PR4cases, SD1case, PD2cases. Signet ring cellcarcinoma1case, the effect of chemotherapy achieved the SD. Survivalperiod the longest is14months, the shortest for5months.Conclusion:1、Some primary focal huge cases，primary tumorshave been shrunk after neoadjuvant chemotherapy， to avoid thepossibility of total gastric resection.2、Lymph nodes have significantlybeen reduced or shrunk to create conditions for operation.3、Neoadjuvant chemotherapy have obvious effect for moderatelydifferentiated adenocarcinoma.4、 Neoadjuvant chemotherapy foradvanced gastric cancer patients to extend the value of survival needsfurther research. |
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