Wesolowski Robert, Lee Chan, Kim Richard
Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Lancet Oncol. 2009 Sep;10(9):903-12. doi: 10.1016/S1470-2045(09)70136-6.
Gastric cancer remains one of the most common forms of cancer worldwide. Unfortunately, most patients will present with advanced-stage disease, and will therefore need palliative chemotherapy. Some chemotherapy regimens have been well established as first-line therapy, and have been shown to increase survival; however, almost all patients with metastatic gastric cancer will develop progressive disease after first-line therapy. With the availability of several active chemotherapy drugs, many patients who retain a good performance status after the initial treatment remain good candidates for additional therapy; however, no standard approach for second-line therapy exists. Many small, phase 2 trials have been done and the findings are variable. No data from randomised-controlled trials suggest a benefit of second-line chemotherapy compared with supportive care alone. We review the published data concerning the use of chemotherapy in the second-line setting for the treatment of advanced gastric cancer.
胃癌仍是全球最常见的癌症形式之一。不幸的是，大多数患者就诊时已处于疾病晚期，因此需要接受姑息化疗。一些化疗方案已被确立为一线治疗方案，并已证明可提高生存率；然而，几乎所有转移性胃癌患者在一线治疗后都会出现疾病进展。随着多种有效化疗药物的出现，许多在初始治疗后仍保持良好身体状况的患者仍是接受额外治疗的合适人选；然而，二线治疗尚无标准方法。已经开展了许多小型的2期试验，结果各不相同。随机对照试验的数据均未表明二线化疗相较于单纯支持治疗有任何益处。我们回顾了已发表的有关在二线治疗中使用化疗治疗晚期胃癌的数据。
