目的 觀察多西他賽三藥及兩藥聯合對胃癌根治術后輔助化學療法（化療）的療效比較及不良反應。 方法 回顧性分析解放軍總醫院2006年1月－2011年12月42 例胃癌根治術后患者的臨床資料，其中有22例、20例患者分別接受以多西他賽為基礎的三藥、兩藥聯合輔助化療。三藥聯合：多西他賽注射液+鉑類+氟尿嘧啶/卡培他濱片/替吉奧；兩藥聯合：多西他賽注射液+氟尿嘧啶/卡培他濱片/替加氟或多西他賽注射液+鉑類；主要觀察終點：無疾病生存期（DFS），次要觀察終點：預后因素分析、復發轉移情況、不良反應及亞組分析。 結果 兩組中位DFS分別為9.530、7.170個月（P=0.646）；性別、年齡、腫瘤浸潤深度、脈管癌栓、淋巴結清掃范圍是患者早期復發轉移的不良預后因素，三藥聯合組肝轉移率高于兩藥聯合組（P=0.008）；主要不良反應為惡心、嘔吐、白細胞減少、腹瀉、脫發、血小板減少等，多為1～2級，可耐受，三藥聯合組較兩藥聯合組易出現不良反應（P=0.011），以惡心、嘔吐為主。 結論 胃癌根治術后以多西他賽為基礎的輔助化療三藥、兩藥聯合對患者療效及預后無明顯差異，且兩種輔助療法不良反應基本可耐受。
ObjectiveTo review and summarize the clinical data and survival information of patients with cholangiocarcinoma treated by surgery, and to explore the clinical and pathological features of cholangiocarcinoma, and the relationship between intraoperative and postoperative characteristics and prognosis. MethodsWe retrospectively analyzed the clinical data of 678 cholangiocarcinoma patients after operation in the PLA General Hospital from January 2004 to December 2010, including the follow-up results of 397 cases. Only 293 patients with surgical resection of cholangiocarcinoma and non-surgical reasons for death were analyzed using Cox proportional hazards model. All indicators were analyzed by univariate and multivariate analysis. ResultsThe median follow-up time was 55.9 months. As of the end of follow-up, there were 158 cases of recurrence (53.9%) and 223 cases of death (76.1%). The median overall survival time was 21.2 months, and 1-year, 3-year and 5-year survival rates were 71.7%, 38.2% and 10.6%, respectively. Tumor differentiation, TNM stage, surgical margin, intraoperative blood transfusion, tumor location, alkaline phosphatase levels in blood and recurrence were independent risk factors for overall survival time. ConclusionLow degree of tumor differentiation, advanced TNM stage, cancer invasion on the surgical margin, intraoperative blood transfusion, tumor located outside the liver, alkaline phosphatase levels in blood higher than normal, and cholangiocarcinoma tumor recurrence are risk factors for overall survival rate in patients with cholangiocarcinoma.