ObjectiveTo compare the clinical effects of continuous hyperthermic peritoneal perfusion chemotherapy (CHPPC) and intravenous chemotherapy for advanced gastric cancer patients, and find better nursing methods. MethodsSixty advanced gastric cancer patients who underwent chemotherapy between June 2013 and June 2014 were divided into CHPPC group (group C, n=30) and intravenous chemotherapy group (group V, n=30). We recorded the nursing methods for both the two groups, patients' satisfaction to the nursing and treatment, peritoneal metastasis rate and quality of life during the chemotherapy. ResultsThe life quality in group V was lower than that in group C (P<0.05). The differences in patients' satisfaction rate, peritoneal metastasis rate, and one-year survival rate were not significantly different between the two groups (P>0.05). ConclusionFor patients with advanced gastric cancer requiring chemotherapy, in spite of higher cost and more complicated operations, CHPPC is superior in lower adverse events rate, better quality of life during chemotherapy and doesn't decrease patients' satisfaction to the nursing and treatment.
ObjectiveTo summarize controversy and progress of multi-slice spiral CT in efficacy evaluation of transformation therapy for advanced gastric cancer.MethodThe recent studies published at home and abroad on the spiral CT in evaluating the therapeutic effect of transformation therapy for the advanced gastric cancer were reviewed and analyzed.ResultsIn recent years, though the energy spectrum and dual-energy CT examinations had appeared, the most common tool in evaluating of the efficacy of transformation therapy for the advanced gastric cancer was the spiral CT. The most common evaluation standard was still the RECIST standard.ConclusionsSpiral CT has its outstanding diagnostic significance in therapeutic evaluation of transformation therapy for advanced gastric cancer. Although there is some controversy, with advancements of a large number of studies, it will greatly help diagnosis and treatment of advanced gastric cancer.
ObjectiveTo observe the clinical curative effect of interventional chemotherapy in the treatment of advanced gastric cancer. MethodsThirty advanced gastric cancer patients underwent arterial infusion chemotherapy and embolization treatment between January and December 30, 2013. The treatment was carried out every three weeks. We evaluated the clinical results after the third treatment. The clinical improvement was assessed based on alleviation of such symptoms as epigastric pain, poor appetite, nausea, vomiting and fecal occult blood. The tumor size was evaluated through abdominal CT examination. ResultsAbdominal pain relieved in 19 out of 28 patients (67.9%); appetite improved in 18 out of 24 patients (75.0%); vomiting relieved in 15 out of 16 cases (93.8%); and fecal 9 out of 12 patients with positive occult blood turned to negative (75.0%). The total effective rate was 83.3%, and 8 patients accepted interventional therapy after operation. The survival rates during the 6, 12 and 24-month follow-up were respectively 85.0%, 65.0%, and 25.0%. ConclusionsInterventional chemotherapy and embolization treatment are effective for advanced gastric cancer, which can relieve symptoms and lower tumor stage. Some patients have a second chance of operation, which can be an effective method in the treatment of advanced gastric cancer.
ObjectiveTo evaluate the relationship between methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism and efficacy of fluorouracil-based chemotherapy in patients with advanced gastric cancer (AGC). MethodsComputer retrieval in China Journal Full-text Database, Chinese Science and Technology Periodical Database, Wanfang database, Chinese Biomedical Literature Database, PubMed, EMbase, Cochrane Library and Web of Science Database (from their establishment to May 28, 2013) was performed to include case-control studies on MTHFR gene C677T polymorphism and sensitivity to fluorouracil-based chemotherapy in patients with advanced gastric cancer. Statistical analysis was done by using RevMan 5.1 software. ResultsSeven case-control studies with 775 patients were included. The meta-analysis showed that among MTHFR C677T genotypes, for TT vs. CC, OR=4.63, 95%CI (1.23, 17.4); and for CC+CT vs. TT, OR=0.21, 95%CI (0.06, 0.78). Subgroup analysis of Asian group showed that for TT vs. CC, OR=32.99, 95%CI (11.40,95.42); and for CC+CT vs. TT, OR=0.04, 95%CI (0.02, 0.10). Sensitivity analysis performed according to different detection methods showed that for TT vs. CC, OR=6.03, 95%CI (1.53, 23.72); and for CC+CT vs.TT, OR=0.17, 95%CI (0.04, 0.68). ConclusionPolymorphism of MTHFR C677T gene may be associated with sensitivity to fluorouracil-based chemotherapy in patients with AGC.
Objective To evaluate the effectiveness and safety of lentinan on immune function in patients with advanced gastric cancer. Methods We searched MEDLINE (1969-2006), EMBASE (1984-2006), OVID (1969-2006), CENTRAL (Cochrane Central Register of Controlled Trials in The Cochrane Library) (Issue 4, 2006), the Chinese Biomedicine Database (1978-2006) and CNKI (1978-2006). We also handsearched relevant journals. Pharmaceutical companies were contacted to identify additional randomized controlled trials. We assessed the identified studies in order to include high quality studies. Results Ten studies (containing 786 patients) met the inclusion criteria. Six trials shown that lentinan+FAM had significant efficacy upon patients with advanced gastric cancer compared with FAM in overall response [Plt;0.01, RR1.70, 95%CI (1.39,2.09)]. In three trials, a significant effect of lentinan+FAM group compared with FAM group in quantity of CD3+ T, T4/T8, NK was found, but lower than FAM group in side- effect of digestive system [RR0.71, 95%CI (0.55,0.91)]. The other trail identified there were fewer side effects in lentinan+FAM group compared with FAM group, though did not discribe the overall response. In case the significant heterogeneity, meta-analysis could not be used for the other three trails included, since the components of chemotherapeutic agents (ATP+Co-A+Vc; DDP+ Epirubicin+5FU; 5FU+CF+VP16) were not the same. In the three trials, overall response was statistically significant better in the lentinan group than in the control group, and lentinan group could significantly increase the quantity of CD3+ T, T4/T8, NK compared with control group. Conclusions The present meta-analysis suggested that addition of lentinan to standard chemotherapy provided a significant advantage over chemotherapy alone in terms of efficacy for patients with advanced gastric cancer. However, most of trials included in the review were of low quality, therefore, it is of necessity to conduct multi-center randomized-controlled trials of high quality.
ObjectiveTo explore the value of multi-slice spiral CT (MSCT) in the judgment of N stage and lymph node metastasis of patients with advanced gastric cancer who underwent surgery after transformation therapy.MethodsClinical data of 27 patients with advanced gastric cancer who underwent surgery after transformation therapy, form July 2017 to July 2019 in Affiliated Yantai Yuhuangding Hospital of Qingdao University were analyzed retrospectively, and all of patients underwent SOX regimen transformation therapy. The MSCT enhanced scan was performed before operation, and the postoperative pathology was used as the gold standard. The preoperative N stage and lymph node metastasis groups were evaluated by MSCT enhanced scan and compared with the pathological results.Results Before the operation, MSCT was used to evaluate the lymph node metastasis of the patients with advanced gastric cancer after transformation therapy, and compared with the lymph nodes metastasis of the corresponding pathological results, the accuracy rates of lymph node groups in No.1, No.3, No.5, No.6, No.7, No.8, and No.16 were 77.78% (21/27), 81.48% (22/27), 85.19% (23/27), 88.89% (24/27), 85.19% (23/27), 74.07% (20/27), and 96.30% (26/27), respectively. Compared with pathological results, the total accuracy of N stage after transformation therapy that evaluated by MSCT was 62.96% (17/27), with the Kappa coefficient was 0.419 (P=0.003).ConclusionsMSCT has high accuracy and consistency for the N stage of advanced gastric cancer after transformation therapy. Besides, MSCT has a certain diagnostic rate for lymph node metastasis in patients with advanced gastric cancer in lymph node groups of No.1, No.3, No.5, No.6, No.7, No.8, and No.16.
【摘要】 目的 探讨替吉奥胶囊联合奥沙利铂治疗晚期胃癌的近期疗效和毒性反应。 方法 2010年1-7月，16例晚期胃癌患者根据体表面积来确定初始剂量，体表面积lt;1.25 m2，替吉奥胶囊40 mg/次，2次/d；体表面积1.25~1.5 m2，替吉奥胶囊50 mg/次，2次/d；体表面积gt;1.5 m2，替吉奥胶囊60 mg/次，2次/d，早、晚饭后分别口服1次，连续服用28 d，停药14 d。奥沙利铂注射液130 mg/m2加入5%葡萄糖注射液500 mL避光缓慢静gt;2 h，第1、21天重复，连用2周期。按RECIST 1.1标准评价客观疗效和不良反应。 结果 16例患者中PR 9例（56.3%），SD3例（18.8%），PD 4例（25%），总有效率为69.0%。不良反应主要是血液学毒性、胃肠道反应及外周神经毒性，且均在Ⅰ~Ⅱ。 结论 替吉奥胶囊联合奥沙利铂方案治疗晚期胃癌的近期疗效较好，不良反应可以耐受，值得进一步研究应用。【Abstract】 Objective To explore the early efficacy of Oxaliplatin combined with S1 capsule on advanced gastric cancer and observe the toxicity. Methods A total of 16 patients with advanced gastric cancer from January to July 2010 were treated with chemotherapy: oxaliplatin 130 mg/m2 mixed with 5% glucose injection 500 mL in the first day and repeated in the 21st day; Po after breakfast and dinner: S1 capsule with an initial dose according to the body surface area. Body surface lt;1.25 m2, 40 mg once, twice per day; body surface:1.25-1.5 m2,50 mg once, twice per day; body surface gt;1.5 m2, 60 mg once, twice per day. The medication lasted for 28 days, withdrew for 14 days. All of the patients underwent the treatment for two cycles. Efficacy and toxicities were evaluated according to the RECIST 1.1 standard. Results Of the 16 patients, partial remission (PR) was in nine (56.3%), stable disease was in three (18.8%) (SD), and progression disease was in four (PD). The total response rate was 69.0%. The major toxicities included leucopenia, nausea, vomiting and neurosensory abnormity. Conclusion Oxaliplatin combined with S1 capsule is effective on advanced gastric cancer, and the adverse effects are tolerable.
目的:评价多西他赛(D)联合拓扑替康(T)治疗晚期胃癌的临床疗效和毒性反应。方法:用DT方案治疗晚期胃痛患者47例。结果:可评价疗效者47例,完全缓解(CR)4例,占8.5％:部分缓解(PR)28例,占59.6％:稳定(SD)11例．占23.4％:进展(PD)4例,占8.5％。总有效率:(CR+PR)为68.1％,临床获益率(CR+PR+SD)为91.5％。中位肿瘤进展期(TTP)8.4个月,中位生存期(MST)12.8个月。主要不良反应为骨髓抑制、白细胞减少、胃肠道反应、恶心呕吐、腹泻、口腔粘膜炎,无治疗相关性死亡病例。结论:多西他赛联合拓扑替康治疗晚期胃癌临床缓解率颇高,提高了生存质量,不良反应可耐受,患者治疗依从性好,可以作为晚期胃癌一线治疗方案。