巴一. 胃癌辅助治疗现状和进展[J]. 中国肿瘤临床, 2013, 40(15): 879-882. DOI: 10.3969/j.issn.1000-8179.2013.15.001
引用本文: 巴一. 胃癌辅助治疗现状和进展[J]. 中国肿瘤临床, 2013, 40(15): 879-882. DOI: 10.3969/j.issn.1000-8179.2013.15.001
Yi BA. Development of adjuvant treatment of gastric cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(15): 879-882. DOI: 10.3969/j.issn.1000-8179.2013.15.001
Citation: Yi BA. Development of adjuvant treatment of gastric cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(15): 879-882. DOI: 10.3969/j.issn.1000-8179.2013.15.001

胃癌辅助治疗现状和进展

Development of adjuvant treatment of gastric cancer

  • 摘要: 多学科综合治疗是局限期胃癌现代诊疗的模式,选择何种治疗方案应根据患者的特征而个体化选择。接受了标准D2术后胃癌患者,Ⅱ期患者可选择口服S-1或者XELOX联合化疗,而Ⅲb期及以上给与同步放化疗。单纯术前新辅助化疗可能不是一个理想的提高生存的策略,而围手术辅助化疗更为合理。目前尚无证据证明胃癌术前新辅助化疗/围手术化疗较单纯术后化疗有更好的生存,新辅助化疗的价值更多体现在降期和使不可R0切除的局部晚期肿瘤转化为可切除肿瘤。术前同步放化疗因降期和转化效率高而在不可切除局限期胃癌中更具探索价值。

     

    Abstract: Multidisplinary treatment is the mordent means of local-regional gastric cancer therapy, and individualized treatment decisions are dependent on the patient's characteristics. Stage Ⅱ patients previously treated with standard D2 resection should receive oral administration of S-1 or combination chemotherapy of XELOX. However, patients at stage Ⅲb or at a more advanced stage should receive combination treatment as priority. Concurrent radiochemotherapy was recommended to treat patients that had been operated by D0 or D1 resection. Perioperative chemotherapy is more reasonable than pure neoadjuvant chemotherapy. No evidence has verified that perioperative or neoadjuvant chemotherapy leads to better survival compared with postoperative adjuvant chemotherapy. The value of chemotherapy before operation is rest with the effect of downstaging and conversion of the unresectable tumor to a resectable one. Concurrent radiochemotherapy prior to an operation needs further investigation to affirm its high efficacy of downstaging and conversion.

     

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