Department of Digestive Surgery, Nihon University School of Medicine, 1-8-13 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8309, Japan.
Surg Today. 2010 Apr;40(4):295-300. doi: 10.1007/s00595-009-4148-9. Epub 2010 Mar 26.
In the early 1990s, a combination of 5-fluorouracil (5-FU) and cisplatin was widely adopted to treat advanced gastric cancer; however, no survival advantage over single-agent 5-FU was confirmed by the results of randomized trials conducted over a long period. Recently developed agents such as irinotecan, taxanes (docetaxel), and new oral fluorouracil (S-1) have yielded more promising results, with a response rate of over 50% and a median survival time of over 10 months in combination studies. These newer combination regimens were investigated in various randomized phase III studies to clarify if the newer-generation regimens provided a survival advantage over the older-generation regimens. Based on the findings of a large randomized study, S-1 has become standard in the adjuvant setting after D2 dissection curatively resected stage II and III gastric cancer. This article reviews the recent advances in gastric cancer chemotherapy, especially in Japan.
20 世纪 90 年代初，氟尿嘧啶（5-FU）联合顺铂被广泛用于治疗晚期胃癌；然而，长期随机试验的结果并未证实其比单药 5-FU 更具生存优势。最近开发的药物，如伊立替康、紫杉烷类（多西他赛）和新型口服氟尿嘧啶（S-1）取得了更有希望的结果，联合治疗的应答率超过 50%，中位生存时间超过 10 个月。这些新的联合方案在各种随机 III 期研究中进行了研究，以明确新一代方案是否比老一代方案具有生存优势。基于一项大型随机研究的结果，S-1 已成为可切除的 II 期和 III 期胃癌根治性 D2 手术后辅助治疗的标准方案。本文综述了胃癌化疗的最新进展，特别是在日本的进展。
