| Aims:In this study,105 patients with stage ?-? gastric cancer after D2 radical surgery were collected.And they were divided into two groups according to the treatment protocol,namely,the experimental group(postoperative sequential chemoradiotherapy group)and the control group(postoperative chemotherapy group).By following efficacy and safety of the two groups were compared.Including the comparison of the overall survival rate in the two groups,tumor markers CA125 or CA72-4(abnormal and normal)difference in survival rates between the two groups.The local recurrence rate and distant metastasis rate in 3 years were compared.And we also analyzed and contrasted the differences of related adverse reactions after treatment in the two groups.Methods:Two groups of patients began to receive postoperative adjuvant therapy within 4 weeks after surgery.In the experimental group,intravenous chemotherapy was performed two cycles after the operation,and local radiotherapy was started about two weeks after the end of the two cycles of chemotherapy.Prescription dose for radiotherapy: 45 Gy(1.8 Gy/d).After the end of radiotherapy,the original regimen of chemotherapy was continued for 2-4 cycles.The control group received intravenous chemotherapy for 6-8 cycles directly within 4 weeks after surgery.The chemotherapy regimens of both groups were combined chemotherapy with 5-FU or 5-FU derivatives and platinum,including XELOX and FOLFOX regimens.The overall survival rates of the two groups were analyzed by the Kaplan survival curve and the differences in survival rates between the two groups with tumor markers CA125 or CA72-4(abnormal and normal)were explored.The chi-square test was used to make an assay of whether there were statistical significance between the two groups at the 3-year local recurrence rate and the 3-year distant metastasis rate.And the two groups of radiotherapy and chemotherapy related adverse reactions were compared.Results:In this study,the research has resuled that in patients with stage ?-? gastric cancer of radical surgery the sequential chemoradiotherapy has a better three-year overall survival benefit compared with the chemotherapy alone through Kaplan survival curve analysis.There was a statistically significant difference(P = 0.039).Then,we performed a subgroup analysis of patients with tumor markers CA125 or CA72-4(abnormal and normal)and found that the experimental group with abnormal CA125 or CA72-4 had a better 3-year survival rate than the control group,with a significant difference(P = 0.026).But there was no statistical difference between the two groups with normal tumor markers CA125 or CA72-4 in the analysis of survival rate.In addition,we compared the two groups and found that the 3-year local recurrence rate of the experimental group was lower than that of the control group,and there was a statistical difference(P = 0.040).However,after comparing the two groups,the 3-year distant metastasis rate was no statistically significant difference(P = 0.348).In this article,the comparison of the toxicity and side effects of the two groups during the treatment were also studied.And the results showed that the sequential radiotherapy and chemotherapy did not increase the severe side effects of the patients.Through contrast analysis,there was no significant difference between the two groups.Conclusions: The present study shows that sequential chemoradiotherapy in patients for stage ?-? gastric cancer after radical surgery can achieve better overall survival compared to chemotherapy alone,especially the survival benefit is obvious in patients with abnormal tumor markers CA125 or CA72-4.Meanwhile the sequential chemoradiotherapy can better control on local recurrence.In addition,sequential chemoradiotherapy in the field of therapeutic toxicity and side effects has the same clinical safety and feasibility. |
PDF Full Text Request