| Background and purpose: Gastric cancer has become the common malignanttumor in our country and the second cause of cancer death. As the development of socialeconomy in recent decades, the incidence of gastric cancer, which threats to humanhealth and life seriously, takes on a decline trend worldwide. However, a high rate ofpatients is diagnosed in the progressive phase for that the symptom of early gastriccancer is not obvious and we still lack effective screening for diagnosis. As a result,most of the clinical gastric cancer patients are in the progressive stage. Recently, partialor radical surgical resection is the main treatment, which plays an important role in thecomprehensive therapy. However, surgical resection sometimes is not able to findsubclinical lesions, which is the basic cause of recurrence of gastric cancer with the highlocal recurrence, distant metastasis and low5-year survival rate after surgical treatment.In recent decades, radiotherapy plays an important role in the adjuvant therapy ofpostoperative progressive gastric cancer due to the progress of radiation biology andradiation physics as well as the progess of therapy. Combined adjuvantradiochemotherapy is the common therapy method for postoperative gastric cancer dueto the high local recurrence, low5-year survival rate and distant metastasis aftergastrectomy. Capecitabine is a kind of oral preparations of fluorouracil, which isnon-toxic itself and plays an anti-tumor role within the tumor tissue metabolism into5-fluorouracil after intestinal absorption. In this dissertation, we have discussed curativeeffect, adverse reaction and survival rate of the combined adjuvant radiochemotherapy using capecitabine so as to expound the feasibility of this scheme further.Methods: Fourty consecutive patients who are collected from the affiliatedhospital of Dalian medical university (2010.3-2012.3) treated postoperatively wereanalyzed, including21males and16females. The median age of all the patients was52.4years old and had histologic subtypes of poorly differentitated adenocarcinomatype for20cases, signet ring cell type for6cases, mucinous type for5cases,differentitated adenocarcinoma type for6cases. Furthermore, there are17cases of IIIApatients and20cases of IIIB patients according to gastric cancer TNM staging criteriaof AJCC. The site of the tumor: gastroesophageal junction in5cases, gastric body in14cases, gastric helicobacter of18cases. Patients will be required to fulfill all of thefollowing criteria: No serious basic diseases; the survival time of patients is longer than6months; the patients must have clinically resectable; every patient could undertake thechemotherapy and radiotherapy. All the patients and their families are agreed to receiveradiation and chemotherapy and signed the patent with the hospital. The patients areclassified into two groups. Combined chemotherapy of XELOX was carried out inpatients of the two groups. Then patients of one group were conducted with3D-CRTconsisted of45Gy with the dose of1.8Gy a day and five time a week. Along withradiotherapy chemotherapy using capecitabine was conducted in the dosage of1250mg/m2, twice a day for5weeeks. Compared with the former, patients of the other grouponly received the adjuvant radiotherapy. Then curative effect, adverse reaction andsurvival rate of the two groups were compared.Results: All the patients have accomplished the therapy. The1-year survivalrate of the group with combined radiochemotherapy and the other group with adjuvantradiotherapy is89.5%and61.1%, respectively.(P＜0.05) The responding2-yearsurvival rate is68.4%and33.3%, respectively.(P＜0.05) To be concluded, thepostoperative survival rate of the group with combined radiochemotherapy is higherthan that of group with adjuvant radiotherapy in statistical significant. As to the sideeffect of blood circulation, the platelet declining degree of the former is higher than thelatter with statistical significance. Additionally, the adverse reactions in digestive system of the two groups have no statistically significant difference.Conclusions: The therapy of combined adjuvant radiochemotherapy topostoperative advanced gastric cancer improves the survival rate and decrease localrecurrence and distant metastasis rate with good security and tolerance. |
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