Lise M, Nitti D, Marchet A, Fornasiero A
Istituto di Patologia Chirurgica I, Università di Padova, Italy.
Anticancer Drugs. 1991 Oct;2(5):433-45. doi: 10.1097/00001813-199110000-00001.
In spite of progress made in surgical techniques and intensive care, only a slight improvement in the therapeutic control of gastric carcinoma has been achieved in the last 20 years. In this paper we present a review of controlled clinical trials on adjuvant chemotherapy and chemo-immunotherapy for gastric cancer and this topic is discussed in the light of our experience and that of the Gastrointestinal Group of the European Organization for Research and Treatment of Cancer. The results of adjuvant therapy are less satisfactory in Western countries than in Japan. The efficacy of the 5-fluorouracil + adriamycin + mitomycin C regimen in advanced gastric cancer has not been confirmed in an adjuvant setting. The therapeutic benefit reported in Japanese studies may be due to a chemotherapy started intraoperatively or during the immediate postoperative period and should also be considered in the light of a standardized surgical treatment. The new therapeutic trends, using recent chemotherapeutic associations tested in Phase I and II clinical trials or combining traditional chemotherapy with different types of immunostimulators, are discussed. Only when large-scale clinical studies have been made will it be possible to confirm their therapeutic efficacy.
尽管手术技术和重症监护取得了进展，但在过去20年里，胃癌的治疗控制仅略有改善。在本文中，我们对胃癌辅助化疗和化疗免疫疗法的对照临床试验进行了综述，并根据我们的经验以及欧洲癌症研究与治疗组织胃肠组的经验对该主题进行了讨论。辅助治疗在西方国家的效果不如日本。5-氟尿嘧啶+阿霉素+丝裂霉素C方案在晚期胃癌中的疗效在辅助治疗中尚未得到证实。日本研究报告的治疗益处可能归因于术中或术后即刻开始的化疗，也应结合标准化手术治疗来考虑。文中讨论了使用在I期和II期临床试验中测试的最新化疗联合方案或传统化疗与不同类型免疫刺激剂联合的新治疗趋势。只有进行大规模临床研究后，才有可能证实它们的治疗效果。
