Liu Na, Wang Xin
Xijing Hospital of Digestive Diseases, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2015 Oct;18(10):983-5.
Recently the standard treatment for advanced gastric cancer is the multimodal therapies associated with complete surgical resection of cancer (D2 dissection) and now more and more clinical attentions have been paid to chemotherapy. It has been confirmed by several randomized phase III( clinical trials that adjuvant chemotherapy after D2 dissection can significantly improve patients' survival. But it is still in debate that perioperative chemotherapy(adjuvant and neoadjuvant) and postoperative radiotherapy can really bring survival benefits for gastric cancer patients who received curative D2 dissections. Based on these questions, investigators designed different ongoing clinical trials in order to define subsets of patients who will more likely benefit from specific therapies and optimize the regimens and sequence. Meanwhile, along with the deep research of gastric cancer biomarkers and introduction of novel molecular subtypes of gastric cancer based on cancer genome atlas project, personalized or individual chemotherapy treatment will come into reality for improving survival and having better life quality for gastric cancer patients.
目前,晚期胃癌的标准治疗方法是与癌症完全手术切除(D2 根治术)相关的多模式治疗,现在越来越多的临床关注集中在化疗上。多项随机 III 期临床试验已证实,D2 根治术后辅助化疗可显著提高患者生存率。但围手术期化疗(辅助化疗和新辅助化疗)以及术后放疗是否真的能为接受根治性 D2 根治术的胃癌患者带来生存益处仍存在争议。基于这些问题,研究人员设计了不同的正在进行的临床试验,以确定更可能从特定治疗中获益的患者亚组,并优化治疗方案和顺序。与此同时,随着对胃癌生物标志物的深入研究以及基于癌症基因组图谱项目引入新的胃癌分子亚型,个性化或个体化化疗治疗将成为现实,以提高胃癌患者的生存率并改善其生活质量。