Toneto Marcelo Garcia, Viola Luciana
Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Porto Alegre, RS, Brazil.
Arq Bras Cir Dig. 2018;31(2):e1373. doi: 10.1590/0102-672020180001e1373. Epub 2018 Jul 2.
The complexity of the management of gastric cancer requires a multidisciplinary evaluation of patients with this tumor. Several treatments have been employed, associated to the surgical resection.
To review the available therapeutic alternatives for the treatment of gastric adenocarcinoma.
A review of selected articles on multidisciplinary treatment of gastric adenocarcinoma in the Pubmed and Medline databases between 2000 and 2017 was carried out. The following headings were related: stomach cancer, treatment, chemotherapy and radiotherapy.
There are several valid alternatives, with good results for the treatment of gastric cancer: chemoradiotherapy or chemotherapy in the adjuvant scenario; perioperative chemotherapy; and chemoradiotherapy after neoadjuvance with isolated chemotherapy.
Current evidences suggest that combined multidisciplinary treatment is superior to surgery alone. However, the optimal treatment regimen is not yet established, and depends on a number of factors, especially the type of surgical resection employed. Therefore, the therapeutic decision should be made by a multidisciplinary team, assessing patient's personal characteristics, biology of the tumor, residual disease, risks and side effects.
胃癌治疗的复杂性要求对患有这种肿瘤的患者进行多学科评估。已经采用了几种与手术切除相关的治疗方法。
回顾治疗胃腺癌的可用治疗选择。
对2000年至2017年期间在Pubmed和Medline数据库中关于胃腺癌多学科治疗的选定文章进行了综述。相关的主题如下：胃癌、治疗、化疗和放疗。
有几种有效的治疗选择，对胃癌的治疗效果良好：辅助治疗中的放化疗或化疗；围手术期化疗；以及在新辅助化疗后单独化疗后进行放化疗。
目前的证据表明，多学科联合治疗优于单纯手术治疗。然而，最佳治疗方案尚未确定，并且取决于许多因素，特别是所采用的手术切除类型。因此，治疗决策应由多学科团队做出，评估患者的个人特征、肿瘤生物学、残留疾病、风险和副作用。
