Clinical application of neoadjuvant therapy in advanced gastric cancer and its effect on prognosis

Objective To explore the clinical application of neoadjuvant therapy in advanced gastric cancer and its effect on prognosis. Methods Eighty-six advanced gastric cancer patients were selected as research subjects and randomly divided into observation group( n = 43) and control group( n =43). The observation group was treated with preoperative neoadjuvant chemotherapy and the postoperative adjuvant chemotherapy,while the control group was only treated with the adjuvant chemotherapy after operation. The effects of preoperative chemotherapy of the patients in the observation group and the toxic reactions,radical resection rates,1-year recurrence rates,the postoperative 2-year survival rates of the two groups were observed and analyzed. Results In the observation group,43 patients were treated with neoadjuvant chemotherapy treatment and the clinical effectiveness rate was 74. 4%. A total of 37 patients underwent radical operations of gastric cancer,accounting for 86 % of patients in the group,while 28 patients in the control group underwent the radical operation of gastric cancer,accounting for 65. 1 %. The ratio of the patients in the observation group undergoing the radical operation was significantly higher than that in the control group( P 0. 05). The ratio of the patients undergoing the distal gastrectomy in the observation group was higher than that of the control group( P 0. 0 5). The ratio of the gastrointestinal toxicity reactions of the patients in the observation group and the control group were 76. 7% and 72. 1% respectively and the differences between the two groups were not statistically significant( P 0. 05). The ratio of the bone marrow inhibition of the patients in the two groups patients were 9. 3% and 7% respectively and the difference between the two groups was not significant( P 0. 05). When the symptomatic treatments were given,all the patients could finish the chemotherapy smoothly. No severe complications and deaths were observed. The tumor recurrence rates after 1-year of the patients in the observation group and the control group were 11. 6% and 32. 6% respectively and there were significant differences between the two groups( P 0. 05). The time of tumor recurrence in the observation group was significantly longer than that of the control group( P 0. 05). The 2-year survival rates of the patients in the two groups were 90. 7 % and 72. 1 % respectively and the difference between the two groups was statistically significant( P 0. 05). Conclusion The neoadjuvant treatment can effectively control the deterioration of advanced gastric cancer,benefit the tumor resection and can significantly reduce the recurrence rate,delay the time to recurrence and improve the survival rate. The treatment plays a positive role in improving the prognosis of patients,has high safety and patient tolerance,and is worthy of the clinical application.