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可切除胃癌综合治疗模式变化分析
邢鹏飞, 周宁, 杨咏强, 张力元, 田野
苏州大学附属第二医院放疗科 苏州大学放射肿瘤治疗学研究所 215004
Changes of multimodality therapeutic patterns of care study for resectable gastric cancer
Xing Pengfei, Zhou Ning, Yang Yongqiang, Zhang liyuan, Tian Ye
Department of Radiotherapy & Oncology, The Second Affiliated Hospital of Soochow University, Institute of Radiotherapy & Oncology, Soochow University, Suzhou 215004, China
Abstract：Objective To investigate and analyze the current status of multimodality therapy for resectable gastric cancer, aiming to provide reference for optimizing the multimodality treatment strategy for gastric cancer. Methods Clinical data of patients diagnosed with gastric adenocarcinoma undergoing radical gastrectomy in the Second Affiliated Hospital of Soochow University were retrospectively analyzed. Clinical characteristics, preoperative medical comorbidities,pathological features, surgical and perioperative status and clinical efficacy were recorded. The gap between the diagnosis and treatment procedures and the standard guidelines was analyzed. The changes in the multimodality treatment patterns for gastric cancer were understood. Results A total of 265 patients were included in this study. All patients were divided into two cohorts:early[2008] and late[2013] cohorts. In the early cohort, 127 patients were assigned, and 138 cases in the late cohort. In the early cohort, 67 patients (52.8%) underwent D2 lymph node dissection, significantly less than 83 patients (60.1%) in the late cohort (P<0.01). In the early and late cohorts, the proportion of patients with the number of lymph node dissection of ≥15 was 5.5% and 52.8%(P<0.01). The median number of lymph node dissection was increased from 6 to 16. The proportion of patients receiving neoadjuvant chemotherapy in the early and late cohorts was 2.4% and 3.6%(P=0.55). In the early cohort,the proportion of patients treated with postoperative chemotherapy and postoperative adjuvant chemoradiotherapy was 62.6% and 2.4%, significantly higher compared with 58.0% and 8.0% in the late cohort (P=0.04). In addition, the proportion of patients receiving postoperative chemotherapy in the early cohort was 62.2%(n=79) and 58.0%(n=80) in the late cohort (P=0.48). Conclusions Although the level of radical gastrectomy has been continuously improved and standardized in China, which still lags behind the standard D2 radical gastrectomy in Japan and South Korea. Adjuvant therapies including postoperative adjuvant radiotherapy can bring clinical benefits. However, the proportion of patients receiving adjuvant therapy is still low, and the multimodality therapy of gastric cancer should be widely applied.
Xing Pengfei,Zhou Ning,Yang Yongqiang et al. Changes of multimodality therapeutic patterns of care study for resectable gastric cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(5): 457-461.
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