Cancer. 1990 Dec 1;66(11):2324-30. doi: 10.1002/1097-0142(19901201)66:11<2324::aid-cncr2820661112>3.0.co;2-c.
In previous Gastrointestinal Tumor Study Group (GITSG) reports, gastric cancer patients with locally unresectable disease, treated with combined radiation and chemotherapy had a shorter median survival (40 weeks) but more remained alive at 4 years (18%) when compared to those randomized to receive chemotherapy alone (76 weeks and 6%, respectively). To further test the concept that combined modality therapy might increase the number of long-term survivors, a second protocol was designed, but with three major modifications. A course of chemotherapy would precede the 5-fluorouracil-potentiated radiation therapy. Doxorubicin would be added to the 5-fluorouracil plus methyl-CCNU combination. Radiation therapy would be given as a single course of 4320 cGy, with 5-fluorouracil given daily for 3 days at the beginning and end of the course. Median survival of 46 patients treated with chemotherapy alone was 59 weeks, with 11% alive after 3 years. Following combined modality therapy, median survival was 62 weeks, but only 7% lived 3 years. Although the problem of early deaths in the combined modality group was resolved, long-term survival with combination therapy was not demonstrated in this study.
在先前胃肠道肿瘤研究组（GITSG）的报告中，局部无法切除的胃癌患者接受放疗与化疗联合治疗时，其生存期的中位数较短（40周），但与随机分配接受单纯化疗的患者相比（分别为76周和6%），4年时仍存活的患者更多（18%）。为了进一步验证联合治疗方式可能增加长期存活者数量的概念，设计了第二个方案，但有三项主要修改。在5-氟尿嘧啶增强放疗之前进行一个化疗疗程。将阿霉素添加到5-氟尿嘧啶加甲基环己亚硝脲的联合用药中。放疗采用单次4320厘戈瑞的疗程，在疗程开始和结束时的3天内每天给予5-氟尿嘧啶。46例接受单纯化疗的患者生存期的中位数为59周，3年后有11%存活。联合治疗后，生存期的中位数为62周，但只有7%存活3年。尽管联合治疗组早期死亡的问题得到了解决，但本研究未证实联合治疗能实现长期存活。
