Kelsen D
Gastrointestinal Section, Memorial Sloan-Kettering Cancer Center, New York, NY.
Isr J Med Sci. 1988 Sep-Oct;24(9-10):557-61.
Gastric cancer remains a common malignancy with poor prognosis. Although surgery is possible in 80 to 90% of patients, less than 50% will have resectable disease and most of these patients will have recurrences. Many chemotherapy studies have been performed in patients with advanced carcinoma of the stomach. At least five conventional agents have been identified as having modest to moderate activity. It is unclear whether combination chemotherapy is more effective in terms of survival rate. Several new chemotherapeutic agents are being studied for gastric cancer, but none have yet proven to be more useful than conventional drugs. Although the rationale for adjuvant chemotherapy in gastric cancer is well established, a substantial number of prospective, controlled randomized trials in Western countries have failed to consistently demonstrate benefit. Thus, for patients with resectable disease who remain at high risk for recurrence, the preferred option is entry into a carefully planned investigation. In the absence of a research protocol, there are no data to support the routine use of chemotherapy in an adjuvant setting for stomach cancer.
胃癌仍然是一种常见的恶性肿瘤，预后较差。尽管80%至90%的患者可以接受手术，但只有不到50%的患者患有可切除疾病，而且这些患者中的大多数都会复发。许多针对晚期胃癌患者的化疗研究已经开展。至少有五种传统药物已被确定具有一定至中等程度的活性。联合化疗在生存率方面是否更有效尚不清楚。几种新型化疗药物正在针对胃癌进行研究，但尚未证明比传统药物更有效。尽管胃癌辅助化疗的基本原理已得到充分确立，但西方国家大量前瞻性、对照随机试验未能始终证明其益处。因此，对于复发风险仍然很高的可切除疾病患者，首选方案是参与精心规划的研究。在没有研究方案的情况下，没有数据支持在胃癌辅助治疗中常规使用化疗。
