Morabito Alessandro, Carillio Guido, Longo Raffaele
Clinical Trials Unit, National Cancer Institute, Via Mariano Semmola, 80131 Naples, Italy.
Crit Rev Oncol Hematol. 2009 Jun;70(3):216-34. doi: 10.1016/j.critrevonc.2008.08.005. Epub 2008 Oct 1.
Treatment of gastric cancer is improved over the past years, but unanswered questions remain regarding the efficacy of systemic treatments in adjuvant, neoadjuvant and metastatic setting. It has not been definitively demonstrated the efficacy of adjuvant chemotherapy, that should not be adopted as a standard approach to localized gastric cancer. On the contrary, compelling evidence in support of perioperative chemotherapy with ECF regimen has been recently provided by the MAGIC trial, although many criticisms have been moved to this study. For metastatic setting, a recent meta-analysis showed a small, but significant survival benefit for combination vs single agent chemotherapy, and the V-325 trial demonstrated the superiority of a docetaxel containing regimen (DCF) over a doublet (CF). Finally, the results of ongoing clinical trials on a number of new molecular-targeted drugs should confirm their role in gastric cancer.
在过去几年中，胃癌的治疗有所改善，但关于全身治疗在辅助、新辅助和转移情况下的疗效仍存在未解决的问题。辅助化疗的疗效尚未得到明确证实，不应将其作为局限性胃癌的标准治疗方法。相反，MAGIC试验最近提供了支持采用ECF方案进行围手术期化疗的有力证据，尽管该研究受到了许多批评。对于转移情况，最近的一项荟萃分析显示，联合化疗与单药化疗相比有微小但显著的生存获益，V-325试验证明含多西他赛方案（DCF）优于双药方案（CF）。最后，正在进行的多项新型分子靶向药物临床试验结果应能证实它们在胃癌治疗中的作用。
