摘要
胃癌病死率在恶性肿瘤中居第2位,且诊断时多为局部晚期。早期发现可以通过根治性手术获得很好的效果。但根治性切除后仍然有很多病人出现局部复发或远处转移。因此,需要其他治疗手段联合手术治疗以期提高疗效。胃癌的辅助化疗已有40余年的历史,虽然有许多研究证实了辅助化疗可以改善病人生存,但由于方案老旧,说服力不强。2010年美国医学会杂志(JAMA)杂志发表的17项研究的荟萃分析证实了以5-氟脲嘧啶(5-FU)为基础的辅助化疗与单纯的术后观察可以提高总存活率。CLASSIC和ACTS-GC的进一步研究证实胃癌D2根治术后的辅助化疗可明显改善病人的无病存活率和总存活率。
Gastric cancer is the second leading cause of death from malignant disease and most frequently discovered in advanced stages. Because curative surgery is regarded as the only option for cure, early detection of resectable gastric cancer is extremely important for good outcomes.Despite radical surgery, a significant percentage of patients undergoing curative resection do relapse, leading to poor overall survival.The recurrence is a result of occult metastatic disease in the tumor bed or distant sites, leading to an interest in the use of other forms of therapy to complement the surgical resection.Over the past 40 years, multiple randomized studies have evaluated the role of adjuvant chemotherapy in gastric cancer.Unfortunately, many of programs have used old,＂suboptimal＂ regimens and were underpowered for survival. The recent（JAMA 2010） meta-analysis containing data from 17 randomized controlled trials demonstrated significant improvement in OS from postoperative adjuvant 5-FU-based chemotherapy when compared with surgery alone. The ACTS-GC and the CLASSIC studies evaluated the role of chemotherapy after D2 resection surgery. The two studies reported a significant benefit in DFS and OS from adjuvant chemotherapy.
出处
《中国实用外科杂志》
CSCD
北大核心
2014年第7期629-633,共5页
Chinese Journal of Practical Surgery
关键词
胃癌
辅助化疗
gastriccancer
adjuvant chemotherapy
