Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, Florence, Italy.
Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
Radiol Med. 2024 Nov;129(11):1710-1719. doi: 10.1007/s11547-024-01892-x. Epub 2024 Oct 1.
Patients affected by resectable locally advanced gastric cancer (GC) should receive perioperative chemotherapy as a standard of care. However, an additional benefit of adjuvant chemoradiation (CRT) has been negated by modern trials in the era of extended surgical dissection, and CRT is currently only considered on an individual basis in case of suboptimal resection. However, the dismal prognosis of GC and the modest treatment completion rates of perioperative chemotherapy have pushed to reconsider CRT, particularly as a preoperative treatment, in light of modern treatment techniques, advances in the understanding of the immune landscape and development of targeted agents. The aim of this review is to critically assess the historical role of CRT, the limitations of current evidence and to debate its potential role in an integrated neoadjuvant strategy for patients with resectable GC.
可切除局部晚期胃癌（GC）患者应接受围手术期化疗作为标准治疗。然而，在广泛手术解剖的时代，辅助放化疗（CRT）的额外益处已被现代试验否定，并且 CRT 目前仅在切除不充分的情况下考虑个体化应用。然而，GC 的预后不佳和围手术期化疗的治疗完成率较低，促使人们重新考虑 CRT，特别是将其作为术前治疗，这是基于现代治疗技术、对免疫景观的理解进展和靶向药物的发展。本综述的目的是批判性地评估 CRT 的历史作用、当前证据的局限性，并讨论其在可切除 GC 患者综合新辅助治疗策略中的潜在作用。
