新疆医科大学硕士学位论文140例进展期胃癌患者预后因索分析及辅助治疗疗效评价姓名：李宾申请学位级别：硕士专业：肿瘤学指导教师：包永星2010-04140例进展期胃癌患者预后因素分析及辅助治疗疗效评价研究生：李宾导师：包永星教授摘要目的：通过对进展期胃癌术后患者预后影响因素的分析及辅助治疗疗效评价，探讨相关预后的因索，明确胃癌术后治疗有无肯定疗效，并对各种化疗方案疗效进行评估，以期提高对胃癌的认识和治疗水平。方法：收集140例进展期胃癌根治术后患者的临床病理资料，对影响进展期胃癌预后的因素进行单因素及Cox比例风险冋归模型分析，并根据治疗模式的不同分成单纯手术切除组、辅助化疗治疗组及辅助放化治疗组。对化疗方案、生存期、毒副作用进行评价。结果：140例患者屮位生存时间23.47月，3年累积生存率31%。手术切除组屮位生存时间13月，3年累积生存率0.0%;辅助化疗治疗组屮位生存时间25月，3年累积生存率39.9%;辅助放化疗治疗组小位生存时间24月，3年累积生存率20.7%。手术切除组与其它两组间统计学丄有显著性差异(P=0.001)o未发现疗效显著的化疗方案。辅助治疗组未出现严重毒副作用。单因素分析显示民族、肿瘤分期、KPS评分、分化程度、浸润深度及辅助治疗方式与预后相关(PV0.05)。多因素分析显示肿瘤分期、KPS评分及病理分化程度为影响预后的独立因索。结论：进展期胃癌患者预后与肿瘤分期、KPS评分及病理分化程度等因素相关。胃癌的治疗以手术切除为主，进展期胃癌的辅助治疗可以延长生存吋间。关键词：胃癌；预后；辅助治疗140CasesofAdvancedGastricCancerPatientswithPrognosticFactorAnalysisandEvaluationofEfficacyofAdjuvantTherapyPostgraduate:LibinSupervisor:Prof.BaoyongxingAbstractObjective:Toanalysestheresultsofprognosisfactorsandmutiplctherapyprogramforpatientswithgastriccancer,weexpecttofindsomeundocumentedprognosticfactors,andtoevaluatetheeffectofadjuvanttherapy.Methods:atotalof140patientswithgastricadenocarcinoma,whoreceivedgastrectomy,wereincludedinthestudies.Thedataconcerningsurgicaltreatment,pathologicalfactors,regimensofchemotherapyandoutcomewerecollected.thefactorsinfluencingsurvivalwereanalyzedusingunviviate(Log-rank)andmultivariate(Coxmodel)methods.140patientsdividedintothreegroups:operation,adjuvantchemotherapyandcombinedtherapy,survivaltime,chemotherapyregimens,andsideeffectswasevaluated.Results:Themediansurvivaltimewas23.47monthsandtheoverall3-yearsurvivalratewas31%.Themediansurvivaltimeand3-yearsurvivalratewereBmonthsand0.0%inoperationgroup;25monthsand39.9%inadjuvantchemotherapygroup;24monthsand20.7%incombinedtreatmentgrouprespectively.Therewassignificantdifferencebetweenoperationandothergroups(P=0.001)・Non-surgicaltreatmentgroup,noserioussideeffects.Univariateanalysisrevealedthattheethnic,stageofTNM,KPSscores,degreeofdifferentiation,invasiondepthandsupportingtreatmentweresignificantfactorsaffectingthesurvival(P<0.05).Howeverbymultivariateanalysis.onlythestageofTNM,KPSscoresanddegreeofdifferentiationwerefoundtobetheindependentfactors.Conclusion:Theprognosisofpatientswithadvancedgastriccancerdependsontumorstage,andKPSscore,degreeofdifferentiation・Gastriccancertreatmenttosurgicalexcision,adjuvanttreatmentofadvancedgastriccancercanprolongsurvivaltime.Keywards:gastriccancer;prognostic;adjuvanttherapy中英文缩略词对照表英文缩写英文全名中文译名KPSKamofskyperformancestatus卡氏--般状况评分OSoverallsurvival总生存期MSmediansurvivaltime屮位生存期5FU5-fluorouracil5氛尿喀喘HCPTHydroxycamptothecine疑基喜树碱MMCMitomycin丝裂霉素3DCRTthree-dimensionalconformalradiotherapy三维适型放疗CTVClinicaltargetvolume临床靶体积PTVPlanningtargetvolume计划靶体积论文独创性...