Department of Radiation Oncology, Olivia Newton-John Cancer Centre, Austin Health, Melbourne, Australia.
School of Molecular Sciences, La Trobe University, Melbourne, Australia.
Ann Surg Oncol. 2021 Aug;28(8):4151-4157. doi: 10.1245/s10434-021-09639-y. Epub 2021 Mar 10.
The only curative treatment for localised gastric cancer is surgical resection. However, survival outcomes post-surgery alone remain poor, particularly in those with node-positive disease with 5-year survival of approximately 30%. Therefore, additional perioperative treatment strategies such as radiotherapy and/or chemotherapy have been explored to improve survival outcomes. Early studies established the role of postoperative radiotherapy in improving locoregional control. However, there are now several adjuvant treatment options available, with many centres favouring perioperative chemotherapy. The delivery of radiotherapy in the postoperative setting can be challenging, thereby resulting in suboptimal patient compliance. Hence, the role of preoperative radiotherapy is currently being evaluated. This review focuses on and summarises the landmark clinical trials that have established the current role of radiation therapy in patients with resectable gastric and gastroesophageal adenocarcinoma, and highlights the potential for preoperative radiotherapy.
局限性胃癌的唯一治愈性治疗方法是手术切除。然而，单独手术后的生存结果仍然较差，特别是在淋巴结阳性疾病患者中，5 年生存率约为 30%。因此，已经探索了其他围手术期治疗策略，如放疗和/或化疗，以改善生存结果。早期研究确立了术后放疗在改善局部区域控制方面的作用。然而，现在有多种辅助治疗选择，许多中心倾向于围手术期化疗。术后放疗的实施具有挑战性，从而导致患者依从性不佳。因此，术前放疗的作用目前正在评估中。本文综述重点介绍并总结了确立放疗在可切除胃和胃食管腺癌患者中的当前作用的标志性临床试验，并强调了术前放疗的潜力。
