Newton Andrew D, Datta Jashodeep, Loaiza-Bonilla Arturo, Karakousis Giorgos C, Roses Robert E
1 Department of Surgery, 2 Division of Hematology/Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
J Gastrointest Oncol. 2015 Oct;6(5):534-43. doi: 10.3978/j.issn.2078-6891.2015.047.
Although surgical resection remains the only potentially curative treatment for gastric cancer (GC), poor long-term outcomes with resection alone compel a multimodality approach to this disease. Multimodality strategies vary widely; while adjuvant approaches are typically favored in Asia and the United States (USA), a growing body of evidence supports neoadjuvant and/or perioperative strategies in locally advanced tumors. Neoadjuvant approaches are particularly attractive given the morbidity associated with surgical management of GC and the substantial risk of omission of adjuvant therapy. The specific advantages of chemoradiotherapy (CRT) compared to chemotherapy have not been well defined, particularly in the preoperative setting and trials aimed at determining the optimal elements and sequencing of therapy are underway. Future studies will also define the role of targeted and biologic therapies.
尽管手术切除仍然是胃癌（GC）唯一可能治愈的治疗方法，但单纯手术切除的长期效果不佳，促使人们对这种疾病采取多模式治疗方法。多模式策略差异很大；虽然辅助治疗方法在亚洲和美国通常更受青睐，但越来越多的证据支持对局部晚期肿瘤采用新辅助和/或围手术期策略。鉴于GC手术管理相关的发病率以及辅助治疗遗漏的重大风险，新辅助治疗方法特别有吸引力。与化疗相比，放化疗（CRT）的具体优势尚未明确界定，尤其是在术前环境中，旨在确定最佳治疗要素和顺序的试验正在进行中。未来的研究还将确定靶向治疗和生物治疗的作用。
