De Paoli Antonino, Buonadonna Angela, Boz Giovanni, Lombardi Davide, Innocente Roberto, Tumolo Salvatore, Tosolini Giancarlo, Rossi Carlo, Trovò Mauro G, Frustaci Sergio
Radiation Oncology Department, Centro di Riferimento Oncologico (CRO), Istituto Nazionale Tumori, Via Pedemontana Occidentale 12, 33081 Aviano, PN, Italy.
Suppl Tumori. 2003 Sep-Oct;2(5):S58-62.
The positive results recently reported by the Intergroup 0116 Study with adjuvant chemoradiation have stimulated an increasing interest in the combined modality treatment of gastric cancer. The significant improvement in disease-free and overall survival reported in this study was related mainly to an improvement in local control rather than to a decrease in the incidence of metastatic disease. Therefore, new and potentially more effective chemotherapy regimens could be considered and the feasibility of their integration with radiation therapy needs to be explored to further improve the treatment in gastric cancer. Our experience with combined radiation therapy and 5-FU-with or without 5-FU based chemotherapy--in unresectable and in partially or radically resected gastric cancer is retrospectively reviewed. In addition, an initial prospective evaluation of the feasibility and toxicity of radiation and 5-FU following adjuvant chemotherapy with modern platinum containing regimens is reported. Our data and the current available experiences with investigational approaches in gastric cancer involving preoperative chemotherapy and intraoperative radiotherapy will be considered in exploring a new combined modality treatment program.
国际协作组0116研究最近报道的辅助放化疗阳性结果激发了人们对胃癌综合治疗模式的兴趣日益增加。该研究报告的无病生存期和总生存期的显著改善主要与局部控制的改善有关，而非转移性疾病发生率的降低。因此，可以考虑新的、可能更有效的化疗方案，并探索将其与放射治疗相结合的可行性，以进一步改善胃癌治疗。我们回顾性分析了在不可切除、部分切除或根治性切除的胃癌中联合放射治疗和5-氟尿嘧啶（5-FU）（含或不含基于5-FU的化疗）的经验。此外，还报告了对现代含铂方案辅助化疗后放疗和5-FU的可行性及毒性的初步前瞻性评估。在探索新的综合治疗方案时，将考虑我们的数据以及目前在胃癌研究方法方面可获得的经验，这些方法包括术前化疗和术中放疗。
