胃癌轉(zhuǎn)化治療最新研究ppt課件

1、1,胃癌轉(zhuǎn)化治療最新研究解讀,2,主要內(nèi)容,日本最新的一項回顧性研究,晚期不可切除胃癌患者經(jīng)多西他賽、順鉑和,S-1,DCS,化療的轉(zhuǎn)化治療,一項多機(jī)構(gòu)的回顧性研究,Sato Y,et al. Gastric Cancer, 2016: 1-10,3,納入標(biāo)準(zhǔn),年齡,20-80,歲,組織學(xué)證實胃腺癌,不可切除的遠(yuǎn)處轉(zhuǎn)移病灶,M1,可測量病灶（多個,ECOG,評分,0-2,既往未接受過化療,骨髓、肝腎功能良好,Sato Y,et al. Gastric Cancer, 2016: 1-10,4,研究設(shè)計及用藥方案,晚期不可切除胃癌患者,n=100,多西他賽、順鉑和,S-1,DCS,重復(fù)直至毒性不

2、可接受、疾病,手術(shù),化療,進(jìn)展、患者拒絕或可行手術(shù),DCS,方案,S-1 40 mg/m,2,b.i.d,1-14,天,順鉑,60 mg/m,2,多西他賽,60 mg/m,2,第,8,天，每,3,周,Sato Y,et al. Gastric Cancer, 2016: 1-10,5,術(shù)前化療的療效評價,評價指標(biāo),N=100,CR,3,PR,78,SD,19,PD,0,ORR,81,Sato Y,et al. Gastric Cancer, 2016: 1-10,6,術(shù)前化療安全性分析：不良事件主要是血液,學(xué)毒性,N=100,白細(xì)胞減少,63,中性粒細(xì)胞減少,75,貧血,12,血小板減少,10

3、,發(fā)熱性中性粒細(xì)胞減少,12,厭食,34,惡心,32,腹瀉,14,Sato Y,et al. Gastric Cancer, 2016: 1-10,7,手術(shù)轉(zhuǎn)化率,33,R0,切除率,84.8 ,Sato Y,et al. Gastric Cancer, 2016: 1-10,8,術(shù)后輔助化療方案,28/33,的患者接受術(shù)后輔助化療,25,例患者接受,S-1,為基礎(chǔ)的方案患者,18,例,S1,單藥,4,例,S-1,聯(lián)合紫杉醇,2,例,S-1,聯(lián)合順鉑,1,例,DCS,3,例患者接受,CPT-11,方案,術(shù)后,S-1,的化療中位療程為,8,個周期,2-8,1,年完成率為,66.7,12/18,S

4、ato Y,et al. Gastric Cancer, 2016: 1-10,9,該研究還進(jìn)行了以下分析,10,轉(zhuǎn)化,vs,非轉(zhuǎn)化患者：基線不可切除因素數(shù)目,少,不可切除因素,轉(zhuǎn)化治療,n=33,非轉(zhuǎn)化治療,n=67,1,2,24/9,72.7/27.3,23/44,34.3/65.7,Sato Y,et al. Gastric Cancer, 2016: 1-10,P,值,0.001,11,轉(zhuǎn)化,vs,非轉(zhuǎn)化患者：生存時間,長,轉(zhuǎn)化治療,n=33,非轉(zhuǎn)化治療,n=67,MST,95%CI,47.8,28.0,88.5,15.7,12.5,18.8,1,年,OS,97,65.9,3,年,OS,63.6,18.7,5,年,OS,42.4,0,Sato Y,et al. Gastric Cancer, 2016: 1-10,12,R0,切除,vs.R1/R2,切除：生存率,高,P = 0.0002,28,例,R0,切除患者達(dá)到,5,年,OS,的比例為,48.6,MST 47.9,個月,5,例,R1,和,R2,切除,患者比例為,0,MST 21.7,Sato Y,et al. Gastric Cancer, 2016: 1-10,13,降期,R0,