OBJECTIVE: To analyze the tumor recurrence after radical radiotherapy and chemotherapy for advanced gastric cancer and provide more in-depth guidance for clinicians.
METHODS: A retrospective analysis was performed on 171 patients with gastric cancer who received postoperative adjuvant radiotherapy and chemotherapy in our hospital from 2021 to 2023. The Kaplan-Meier method was used to calculate the recurrence rate and survival rate; the log-rank method was used to analyze the single-factor prognosis; and the Cox model was used to analyze the prognosis associated with multiple factors.
RESULTS: The median follow-up time of the whole group was 63 months, and the follow-up rate was 93.6%. Stage II and III patients accounted for 31.0% and 66.7%, respectively. The incidences of Grade 3 and above acute gastrointestinal reactions and hematological adverse reactions were 8.8% and 9.9%, respectively. A total of 166 patients completed the entire chemoradiotherapy regimen, during which no adverse reaction-related deaths occurred. In terms of the recurrence pattern, 17 patients had local recurrence, 29 patients had distant metastasis, and 12 patients had peritoneal implantation metastasis. The 1-year, 3-year, and 5-year overall survival (OS) rates were 83.7%, 66.3%, and 60.0%, respectively. The 1-year, 3-year, and 5-year disease-free survival rates were 75.5%, 62.7%, and 56.5%, respectively. Multivariate analysis revealed that T stage, peripheral nerve invasion, and the lymph node metastasis rate (LNR) were independent prognostic factors for OS.
CONCLUSIONS: Postoperative intensity-modulated radiotherapy combined with chemotherapy for gastric cancer treatment is well tolerated and has acceptable adverse effects, which is beneficial for local tumor control and can improve the long-term survival of patients. The LNR was an independent prognostic factor for OS. For patients with a high risk of local recurrence, postoperative adjuvant chemoradiation should be considered.
目的:分析进展期胃癌根治性放化疗后肿瘤复发情况,为临床医生提供更深入的指导。
方法:回顾性分析2021-2023年在我院接受术后辅助放化疗的171例胃癌患者的临床资料。采用Kaplan-Meier法计算复发率和生存率;采用log-rank法进行单因素预后分析;采用Cox模型进行多因素预后分析。
结果:全组中位随访时间为63个月,随访率为93.6%。Ⅱ期和Ⅲ期患者分别占31.0%和66.7%,分别。3级及以上急性胃肠道反应和血液学不良反应发生率分别为8.8%和9.9%。分别。共有166名患者完成了整个放化疗方案,期间无不良反应相关死亡发生.就复发模式而言,17例患者局部复发,29例患者有远处转移,12例患者发生腹膜种植转移。1年,3年,5年总生存率(OS)为83.7%,66.3%,和60.0%,分别。1年,3年,5年无病生存率为75.5%,62.7%,56.5%,分别。多变量分析表明,T分期,周围神经侵犯,淋巴结转移率(LNR)是OS的独立预后因素。
结论:胃癌术后调强放疗联合化疗治疗耐受性好,不良反应可接受。有利于肿瘤局部控制,提高患者的长期生存率。LNR是OS的独立预后因素。对于局部复发风险高的患者,应考虑术后辅助放化疗.