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1、FOLFOX方案在進(jìn)展期胃癌新輔助化療中的應(yīng)用李國(guó)帥張成武*(青海大學(xué)附屬醫(yī)院胃腸外科810001;*通訊作者，張成武，主任醫(yī)師)胃癌是我國(guó)最常見(jiàn)的惡性腫瘤之一，早期發(fā)現(xiàn)較為網(wǎng)難。據(jù)統(tǒng)計(jì)，我國(guó)住院胃癌患者中，進(jìn)展期占70%?80%[1],而且多伴有淋巴結(jié)轉(zhuǎn)移，手術(shù)仍然為其首選的治療方式。此類患者手術(shù)切除率低,獲得根治性切除的比例較少,5年生存率低，治療效果差。積極提高手術(shù)切除率成為改善胃癌患者預(yù)后的一大目標(biāo)。對(duì)于進(jìn)展期胃癌術(shù)前行輔助化療有助于手術(shù)以及提高術(shù)后存活率、降低復(fù)發(fā)及轉(zhuǎn)移率。臨床上對(duì)于進(jìn)展期胃癌
2、術(shù)前新輔助化療的方案多種多樣，但最常見(jiàn)的仍為FOLFOX方案(奧沙利鉑4■亞葉酸鈣+氟尿嘧啶)。該方案用于進(jìn)展期胃癌新輔助化療有效率較高，不良反應(yīng)多為輕度，經(jīng)對(duì)癥處理后可緩解，未影響后續(xù)治療的進(jìn)行和造成不可逆性損傷，能夠增加腫瘤完全切除的機(jī)會(huì)，提高手術(shù)效果[2]。【關(guān)鍵詞】進(jìn)展期胃癌；新輔助化療；氟尿啼啶；亞葉酸鈣；奧沙利鉑【中圖分類號(hào)】R2【文獻(xiàn)標(biāo)號(hào)】A1671-8725(2014)11-0112-02ApplicationofFOLFOXneoadjuvantchemotherapyregimeni
3、nthetreatmentofadvancedgastriccarcinomaLiGuoshuai;ZhangChengwu(GastrointestinalsurgeryofAffiliatedHospitalofQinghaiUniversity810001;*correspondingauthor,ZhangChengwu,chiefphysician)abstract:Objective:Gastriccancerisoneofthemostcommonmalignanttumorinourco
4、untry,it'sdifficulttomakedetectionearly.HospitalizationinpatientswithgastriccancerinChina,thedevelopmentperiodisabout70%to80%,andmoreassociatedwithlymphnodemetastasis,surgeryisstillthefirstchoiceoftreatment.Patientswithsurgicalresectionrateislow,toobtain
5、theproportionoflessradicalexcision,5-yearsurvivalrateislow,thetreatmenteffectispoor.Activelyimprovetheresectionratebecomeabiggoalofimprovingtheprognosisofpatientswithgastriccancer.Foradvancedgastriccancerlinepreoperativeadjuvantchemotherapyhelpstoimprove
6、operationandpostoperativesurvivalrate,reducetherateofrecurrenceandmetastasis.Foradvancedgastriccancerclinicalpreoperativeneoadjuvantchemotherapyschemeisvaried,butthemostcommonisstillFOLFOXscheme.Theschemeisusedforadvancedgastriccancerneoadjuvantchemother
7、apyhighefficient,adversereactionsaremild,aftersymptomatictreatmentcanalleviate,didnotaffecttheproceedingofthefollow-uptreatmentandcauseirreversibledamage,increasesthechanceofcompletetumorexcision,improvetheeffectofsurgery.KeyWords:Advancedgastriccancer;N
8、eoadjuvantchemotherapy；5-Fluorouracil；Calciumfolinate；Oxaliplatin0前，經(jīng)確診的胃癌仍大多數(shù)為進(jìn)展期胃癌，但進(jìn)展期胃癌的手術(shù)效果遠(yuǎn)遠(yuǎn)差于旱期胃癌。手術(shù)切除是根治胃癌的唯一手段，而進(jìn)展期胃癌通常由于對(duì)周圍組織的侵犯而不能進(jìn)行根治性切除，從而造成了其復(fù)發(fā)率高和生存率低的狀態(tài)。因此，尋求提高進(jìn)展期胃癌根治性切除率的手段具奮重要意義。胃癌新輔助化療又稱術(shù)前化療，其目的是降低腫瘤臨床分期
