Research progress in neoadjuvant and adjuvant therapies for gastric linitis plastica
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摘要: 胃癌是最常见的消化系统恶性肿瘤之一。皮革胃是一种特殊类型的胃癌，大体上呈现为胃壁节段性或弥漫性增厚，镜下可见散在分布的低黏附性肿瘤细胞或印戒细胞，以及弥漫的纤维间质的增生和浸润。皮革胃进展迅速，预后不良。就诊时大部分患者处于进展期，同时伴有隐匿性的腹膜转移，术后中位生存期仅为6～14个月。根治性手术是皮革胃患者最重要的治疗方式，但超过50%的患者在就诊时已丧失根治性手术机会。近年来，以手术为中心的综合治疗模式，包括手术结合术前新辅助治疗、术后辅助治疗等已逐渐应用于皮革胃的治疗，相关分子通路的发现，也为进一步免疫和靶向治疗的研究提供了方向。Abstract: Gastric cancer is globally ranked fifth and fourth in terms of incidence and mortality, respectively. Gastric linitis plastica is a special type of gastric cancer that is macroscopically characterized by segmental or diffuse thickening and gastric wall stiffening. Microscopically, it is characterized by scattered low-adhesion tumor cells or signet-ring cells, in addition to diffuse fibro-stromal proliferation and infiltration. Gastric linitis plastica progressed rapidly and patients with gastric linitis plastica had a poor prognosis. Most patients were at an advanced disease stage with occult peritoneal metastasis at diagnosis. The median postoperative survival duration was only 6–14 months. Radical surgery is the most important treatment approach for patients with gastric linitis plastica. However, more than of half of the patients cannot undergo radical surgery at diagnosis. Recent comprehensive treatment modalities are centered on surgery, including surgery combined with preoperative neoadjuvant therapy or postoperative adjuvant therapy, and are being increasingly applied to treat gastric linitis plastica. The novel discovery of the underlying molecular pathways also provides a direction for further research on immunotherapy and targeted therapy.
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表 1 皮革胃新辅助治疗临床试验汇总
作者 阶段 纳入例数（例） 药物 治疗周期（个） R0切除率（%） PR 不良反应 治疗相关死亡率（%） 生存 Kinoshita等[15] 探索性研究 5 S-1 2 - - - 0 - Kinoshita等[16] Ⅱ期临床试验 55 S-1 2 80.8 32.6 3级：5.4% 0 2年总生存率：60% Iwasaki等[19] Ⅱ临床试验 50 S-1+顺铂 2 66.0 51.0 - 2.0 3年总生存率：4.5%； Iwasaki等[21] Ⅲ临床试验 316 S-1+顺铂 2 - - 3级及以上：19.7% 0.7 3年总生存率：60.9% Hosoda等[24-25] Ⅱ临床试验 40 S-1+多西他赛+顺铂 4 90.0 57.5 0 3年总生存率：77.5%；5年总生存率：69.4% Endo等[27] Ⅱ临床试验 - S-1+多西他赛+奥沙利铂 - - - - - - 
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[1] Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249. doi: 10.3322/caac.21660 [2] Mastoraki A, Papanikolaou IS, Sakorafas G, et al. Facing the challenge of managing linitis plastica: review of the literature[J]. Hepatogastroenterology, 2009, 56(96):1773-1778. [3] Agnes A, Estrella JS, Badgwell B. The significance of a nineteenth century definition in the era of genomics: linitis plastica[J]. World J Surg Oncol, 2017, 15(1):123. doi: 10.1186/s12957-017-1187-3 [4] Wang FH, Zhang XT, Li YF, et al. The Chinese society of clinical oncology (CSCO): clinical guidelines for the diagnosis and treatment of gastric cancer, 2021[J]. Cancer Commun (Lond), 2021, 41(8):747-795. doi: 10.1002/cac2.12193 [5] Mariette C, Carneiro F, Grabsch HI, et al. Consensus on the pathological definition and classification of poorly cohesive gastric carcinoma[J]. Gastric Cancer, 2019, 22(1):1-9. doi: 10.1007/s10120-018-0868-0 [6] Blackham AU, Swords DS, Levine EA, et al. Is linitis plastica a contraindication for surgical resection: a multi-institution study of the U. S. gastric cancer collaborative[J]. Ann Surg Oncol, 2016, 23(4):1203-1211. doi: 10.1245/s10434-015-4947-8 [7] Jung K, Park MI, Kim SE, et al. Borrmann type 4 advanced gastric cancer: focus on the development of scirrhous gastric cancer[J]. Clin Endosc, 2016, 49(4):336-345. [8] Pedrazzani C, Marrelli D, Pacelli F, et al. Gastric linitis plastica: which role for surgical resection[J]. Gastric Cancer, 2012, 15(1):56-60. doi: 10.1007/s10120-011-0063-z [9] Schauer M, Peiper M, Theisen J, et al. Prognostic factors in patients with diffuse type gastric cancer (linitis plastica) after operative treatment[J]. Eur J Med Res, 2011, 16(1):29-33. doi: 10.1186/2047-783X-16-1-29 [10] Thompson RJ, Ranaghan L, Kennedy R, et al. Survival following operative management of gastric linitis plastica compared with non-operative management[J]. Ann R Coll Surg Engl, 2017, 99(3):228-232. doi: 10.1308/rcsann.2016.0337 [11] Chang JM, Lara KA, Gray RJ, et al. Clinical outcomes after surgery for linitis plastica of the stomach: analysis of a population cancer registry[J]. Am Surg, 2017, 83(1):23-29. [12] Frei E 3rd. Clinical cancer research: an embattled species[J]. Cancer, 1982, 50(10):1979-1992. doi: 10.1002/1097-0142(19821115)50:10<1979::AID-CNCR2820501002>3.0.CO;2-D [13] Miao ZF, Liu XY, Wang ZN, et al. Effect of neoadjuvant chemotherapy in patients with gastric cancer: a PRISMA-compliant systematic review and meta-analysis[J]. BMC Cancer, 2018, 18(1):118. doi: 10.1186/s12885-018-4027-0 [14] Ajani JA, D'Amico TA, Bentrem DJ, et al. Gastric cancer, version 2.2022, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2022, 20(2):167-192. doi: 10.6004/jnccn.2022.0008 [15] Kinoshita T, Konishi M, Nakagohri T, et al. Neoadjuvant chemotherapy with S-1 for scirrhous gastric cancer: a pilot study[J]. Gastric Cancer, 2003, 6(Suppl_1):40-44. [16] Kinoshita T, Sasako M, Sano T, et al. Phase II trial of S-1 for neoadjuvant chemotherapy against scirrhous gastric cancer (JCOG 0002)[J]. Gastric Cancer, 2009, 12(1): 37-42. [17] Koizumi W, Narahara H, Hara T, et al. S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial[J]. Lancet Oncol, 2008, 9(3):215-221. doi: 10.1016/S1470-2045(08)70035-4 [18] Ilson DH. Advances in the treatment of gastric cancer: 2019[J]. Curr Opin Gastroenterol, 2019, 35(6):551-554. doi: 10.1097/MOG.0000000000000577 [19] Iwasaki Y, Sasako M, Yamamoto S, et al. Phase II study of preoperative chemotherapy with S-1 and cisplatin followed by gastrectomy for clinically resectable type 4 and large type 3 gastric cancers (JCOG0210)[J]. J Surg Oncol, 2013, 107(7):741-745. doi: 10.1002/jso.23301 [20] Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma-2nd English edition-[J]. Gastric Cancer, 1998, 1(1):10-24. [21] Iwasaki Y, Terashima M, Mizusawa J, et al. Gastrectomy with or without neoadjuvant S-1 plus cisplatin for type 4 or large type 3 gastric cancer (JCOG0501): an open-label, phase 3, randomized controlled trial[J]. Gastric Cancer, 2021, 24(2):492-502. doi: 10.1007/s10120-020-01136-7 [22] Van Cutsem E, Moiseyenko VM, Tjulandin S, et al. Phase III study of docetaxel and cisplatin plus fluorouracil compared with cisplatin and fluorouracil as first-line therapy for advanced gastric cancer: a report of the V325 Study Group[J]. J Clin Oncol, 2006, 24(31):4991-4997. [23] Koizumi W, Nakayama N, Tanabe S, et al. A multicenter phase II study of combined chemotherapy with docetaxel, cisplatin, and S-1 in patients with unresectable or recurrent gastric cancer (KDOG 0601)[J]. Cancer Chemother Pharmacol, 2012, 69(2):407-413. doi: 10.1007/s00280-011-1701-1 [24] Hosoda K, Azuma M, Katada C, et al. A phase II study of neoadjuvant chemotherapy with docetaxel, cisplatin, and S-1, followed by gastrectomy with D2 lymph node dissection for high-risk advanced gastric cancer: results of the KDOG1001 trial[J]. Gastric Cancer, 2019, 22(3):598-606. doi: 10.1007/s10120-018-0884-0 [25] Hosoda K, Katada C, Ishido K, et al. Neoadjuvant chemotherapy plus surgery for high-risk advanced gastric cancer: long-term results of KDOG1001 trial[J]. Langenbecks Arch Surg, 2020, 405(6):777-785. [26] Pentheroudakis G, ESMO guidelines committee. Recent eUpdates to the ESMO Clinical Practice Guidelines on hepatocellular carcinoma, cancer of the pancreas, soft tissue and visceral sarcomas, cancer of the prostate and gastric cancer[J]. Ann Oncol, 2019, 30(8):1395-1397. doi: 10.1093/annonc/mdz180 [27] Endo S, Terazawa T, Goto M, et al. Neoadjuvant docetaxel, oxaliplatin and S-1 therapy for the patients with large type 3 or type 4 gastric cancer (OGSG1902): protocol of a multi-center, phase Ⅱ study[J]. BMC Cancer, 2022, 22(1):811. [28] Tokunaga M, Sato Y, Nakagawa M, et al. Perioperative chemotherapy for locally advanced gastric cancer in Japan: current and future perspectives[J]. Surg Today, 2020, 50(1):30-37. doi: 10.1007/s00595-019-01896-5 [29] Park SH, Sohn TS, Lee J, et al. Phase III trial to compare adjuvant chemotherapy with capecitabine and cisplatin versus concurrent chemoradiotherapy in gastric cancer: final report of the adjuvant chemoradiotherapy in stomach tumors trial, including survival and subset analyses[J]. J Clin Oncol, 2015, 33(28):3130-3136. doi: 10.1200/JCO.2014.58.3930 [30] Yu JI, Lim DH, Lee J, et al. Necessity of adjuvant concurrent chemo-radiotherapy in D2-resected LN-positive gastric cancer[J]. Radiother Oncol, 2018, 129(2):306-312. doi: 10.1016/j.radonc.2018.07.002 [31] Matuschek C, Haussmann J, Bölke E, et al. Adjuvant radiochemotherapy vs. chemotherapy alone in gastric cancer: a meta-analysis[J]. Strahlenther Onkol, 2019, 195(8):695-706. [32] Song XR, Shi Y, Shi T, et al. The efficacy of treating patients with non-metastatic gastric linitis plastica using surgery with chemotherapy and/or radiotherapy[J]. Ann Transl Med, 2020, 8(21):1433. [33] Xue YJ, Zhang LG, Zhu Y, et al. Regulation of proliferation and epithelial-to-mesenchymal transition (EMT) of gastric cancer by ZEB1 via modulating Wnt5a and related mechanisms[J]. Med Sci Monit, 2019, 25:1663-1670. doi: 10.12659/MSM.912338 [34] Takei Y, Shen GD, Morita-Kondo A, et al. MicroRNAs associated with epithelial-mesenchymal transition can be targeted to inhibit peritoneal dissemination of human scirrhous gastric cancers[J]. Pathobiology, 2018, 85(4):232-246. doi: 10.1159/000488801 [35] Monster JL, Kemp LJS, Gloerich M, et al. Diffuse gastric cancer: emerging mechanisms of tumor initiation and progression[J]. Biochim Biophys Acta Rev Cancer, 2022, 1877(3):188719. doi: 10.1016/j.bbcan.2022.188719 -
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