Harada Kazuto, Yamashita Kohei, Iwatsuki Masaaki, Baba Hideo, Ajani Jaffer A
Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Department of Gastrointestinal Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
Expert Rev Clin Pharmacol. 2022 Jan;15(1):43-49. doi: 10.1080/17512433.2022.2044790. Epub 2022 Feb 25.
Gastric adenocarcinoma (GAC) is one of the most aggressive malignancies worldwide and has a poor prognosis. Multidisciplinary therapies are used in its treatment, but the prognosis for GAC patients with peritoneal metastases (PM) remains poor and there is no effective established approach.
This review summarizes the results of recent clinical studies and recent advances in the management, including surgery, chemotherapy, targeted therapy, and immunotherapy. In this review, keywords were searched in combination with 'peritoneal carcinomatosis' and 'gastric cancer' in PubMed, and then studies that evaluated peritoneal carcinomatosis associated with gastric cancer were identified through reading them. Several studies were quoted at second hand. Despite recent advances in therapeutic approaches such as systemic chemotherapy, immunotherapy, intraperitoneal chemotherapy, debulking surgery, thermal hyperthermic intraperitoneal chemotherapy, pressurized intraperitoneal aerosol chemotherapy, immunotherapy, and best supportive therapy, further studies are necessary. This review also summarizes molecular biology of GAC patients with PM.
Each modality is advancing and some have shown therapeutic effects, but none have become standard treatments that exhibit remarkable effects. To improve the prognosis of GAC patients with PM, large-scale clinical trials and further basic research are required.
胃腺癌(GAC)是全球最具侵袭性的恶性肿瘤之一,预后较差。其治疗采用多学科疗法,但伴有腹膜转移(PM)的GAC患者预后仍然很差,且尚无有效的既定治疗方法。
本综述总结了近期临床研究结果以及管理方面的最新进展,包括手术、化疗、靶向治疗和免疫治疗。在本综述中,在PubMed中结合“腹膜癌病”和“胃癌”搜索关键词,然后通过阅读筛选出评估与胃癌相关的腹膜癌病的研究。二手引用了几项研究。尽管在全身化疗、免疫治疗、腹腔内化疗、减瘤手术、热腹腔内化疗、加压腹腔内气溶胶化疗、免疫治疗和最佳支持治疗等治疗方法上取得了最新进展,但仍需要进一步研究。本综述还总结了伴有PM的GAC患者的分子生物学。
每种治疗方式都在不断发展,有些已显示出治疗效果,但尚无成为具有显著效果的标准治疗方法。为改善伴有PM的GAC患者的预后,需要大规模临床试验和进一步的基础研究。