中文摘要：

目的：局部进展期胃癌,即使没有出现远处转移或腹膜种植,预后也极不理想。我们对局部进展期胃癌患者进行术前mECF方案的动静脉结合化疗,以评价其治疗疗效。方法：选取自2009年1月至2011年6月间我院局部进展期胃癌II-IIIC期患者38例,均由影像学确定淋巴结高度可疑转移或浸润、包绕主要血管结构,且没有发现远处转移或腹膜种植,进行2个周期的术前动静脉结合化疗后,行手术治疗。记录化疗毒性反应、临床、病理缓解率、手术并发症发生率和病死率以及1年无病生存率。结果：化疗毒性反应低,3级反应不超过10%,仅有1例出现4级反应,表现为腹泻、恶心和呕吐。38例患者中临床CR有6例,占15.8%,PR17例,占44.7%,NC13例（34.2%）,PD2例（5.3%）,RR为60.5%（23/38）。全部患者均施行了手术,37例患者进行了根治性手术,R0切除率为97%。病理缓解率为5例完全缓解（13.2%）,21例部分缓解（55.3%）,8例轻微缓解（21.1%）,4例未缓解（10.5%）。手术并发症发生率为7.9%,无治疗相关死亡发生。1年无病生存率为81.6%。结论：局部进展期胃癌患者术前进行mECF方案的动静脉化疗毒性反应低,疗效理想,之后行手术完整切除后临床效果突出,是理想的治疗方法。

英文摘要：

Objective： To evaluate the efficacy of preoperative intra-artery and intravenous combination chemotherapy with ECF modification（mECF） regimen in patients with locally advanced gastric cancer（LAGC）.Methods： A total of 38 patients with LAGC,were treated with a preoperative intra-artery and intravenous combination chemotherapy in Liaoning Cancer Hospital Institute between January 2009 and June 2011.Patients received an mECF regimen-a combination of intra-arterial epirubicin（50 mg/m 2 on day 1 of each cycle） and oxaliplatin（130 mg/m 2 on day 1 of each cycle） and oral capecitabine（625 mg/m 2 twice daily on days 1 to 21 of each cycle）,cycled every 21 days.After 2 cycles of preoperative chemotherapy,patients with resectable tumors underwent surgery.The following data were contemporaneously recorded： toxicity,clinical and pathologic response rates,operative morbidity and mortality rates and 1-year disease-free survival（DFS）.Results： Toxicity observed was low,with grade 3 toxicity in fewer than 10% of the patients and one event of grade 4 toxicity（diarrhea,nausea and vomiting）.Six（15.8%） of the 38 patients had clinical complete remission（CR）,and seventeen（44.7%） had partial remission（PR）,no-change（NC） in 13（34.2%）,progressive disease（PD） in two（5.3%）,with the remission rate（RR） of 60.5%（23/38）.All of the patients（100%） underwent surgery;37 of the patients had a curative resection,and the R0 resection rate was 97%.The pathologic response rate included 5 complete responses（13.2%）,21 moderate responses（55.3%）,8 minimal responses（21.1%）,4 Poor responses（10.5%）.The operative morbidity rate was 7.9% and there was no treatment-related death.The 1-year DFS was 81.6%.Conclusion： Preoperative intra-artery and intravenous combination chemotherapy with mECF in patients with LAGC has low toxicity and reasonable efficacy.Clinically responding patients have an excellent outcome after complete resection.It is a reasonable treatment option fo