Schernberg A, Rivin Del Campo E, Rousseau B, Matzinger O, Loi M, Maingon P, Huguet F
Service d'Oncologie Radiothérapie, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Paris, France.
Service d'Oncologie Médicale, Hôpital Henri Mondor, Paris, France.
Clin Transl Radiat Oncol. 2018 Mar 13;10:13-22. doi: 10.1016/j.ctro.2018.02.005. eCollection 2018 Mar.
An estimated 990,000 new cases of gastric cancer are diagnosed worldwide each year. Surgical excision, the only chance for prolonged survival, is feasible in about 20% of cases. Even after surgery, the median survival is limited to 12 to 20 months due to the frequency of locoregional and/or metastatic recurrences. This led to clinical trials associating surgery with neoadjuvant or adjuvant treatments to improve tumor control and patient survival. The most studied modalities are perioperative chemotherapy and adjuvant chemoradiotherapy. To date, evidence has shown a survival benefit for postoperative chemoradiotherapy and for perioperative chemotherapy. Phase III trials are ongoing to compare these two modalities. The aim of this review is to synthesize current knowledge about adjuvant chemoradiotherapy in the management of gastric adenocarcinoma, and to consider its prospects by integrating modern radiotherapy techniques.
据估计，全球每年有99万例新发胃癌病例被诊断出来。手术切除是延长生存期的唯一机会，约20%的病例可行手术切除。即使在手术后，由于局部区域和/或远处转移复发的频率，中位生存期也仅限于12至20个月。这导致了将手术与新辅助或辅助治疗相结合的临床试验，以改善肿瘤控制和患者生存率。研究最多的方式是围手术期化疗和辅助放化疗。迄今为止，证据表明术后放化疗和围手术期化疗对生存有益。正在进行III期试验以比较这两种方式。本综述的目的是综合目前关于辅助放化疗在胃腺癌治疗中的知识，并通过整合现代放疗技术来考虑其前景。
