潛在可切除性胃癌的新輔助化療_《中國普外基礎與臨床雜志》

作者：

肖仕明 , 吳宸 , 姜淮蕪

川北醫學院附屬第二醫院普外二科(四川綿陽 621000);

關鍵詞：

胃腫瘤新輔助治療新輔助化療術前化療

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目的總結潛在可切除胃癌的新輔助化療(neoadjuvant chemotherapy，NAC)的現狀。
方法通過PubMed，以胃腫瘤、胃癌/癌、新輔助治療/化療及術前治療/化療為關鍵詞，檢索近5年的相關文獻。并檢索2007及2008年ASCO年會的相關進展。總結NAC在胃癌中的研究現狀，評價其必要性和可行性，分析病例選擇依據、緩解預測因子及存在的問題和發展方向。
結果共檢索隨機對照試驗7個，其中3個為Ⅲ期試驗。已進行的多數研究顯示，NAC在胃癌的治療中是安全、有效和可行的。但生存取得顯著改善的NAC隨機研究尚少，缺乏嚴格NAC與單獨手術或圍手術期化療與輔助化療對比的NAC隨機研究。如何選擇適當的病例、有效的NAC方案和治療緩解的預測，尚需要解決。
結論 NAC在胃癌的治療中是安全、有效和可行的，但仍需進一步嚴格的前瞻性隨機Ⅲ期試驗證實。新的細胞毒性藥物和分子靶向治療可能是將來進展的實質基礎。

引用本文： 肖仕明,吳宸,姜淮蕪. 潛在可切除性胃癌的新輔助化療. 中國普外基礎與臨床雜志, 2009, 16(8): 680-685. doi: 復制

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3. Cunningham D, Starling N, Rao S, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer[J]. N Engl J Med, 2008; 358(1): 36-46.
4. Foukakis T, Lundell L, Gubanski M, et al. Advances in the treatment of patients with gastric adenocarcinoma[J]. Acta Oncol, 2007; 46(3): 277-285.
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10. Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer[J]. N Engl J Med, 2004; 351(17): 1731-1740.
11. Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction[J]. N Engl J Med, 2001; 345(10): 725-730.
12. Sasako M, Sano T, Yamamoto S, et al. D2 lymphadenectomy alone or with para-aortic nodal dissection for gastric cancer[J]. N Engl J Med, 2008; 359(5): 453-462.
13. Sakuramoto S, Sasako M, Yamaguchi T, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine[J]. N Engl J Med, 2007; 357(18): 1810-1820.
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15. 陳志新, 張波. 胃癌綜合治療現狀及展望 [J]. 中國普外基礎與臨床雜志, 2008; 15(1): 71-73.
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17. Wilke H, Preusser P, Fink U, et al. Preoperative chemotherapy in locally advanced and nonresectable gastric cancer: a phase Ⅱ study with etoposide, doxorubicin, and cisplatin[J]. J Clin Oncol, 1989; 7(9): 1318-1326.
18. Songun I, Keizer HJ, Hermans J, et al. Chemotherapy for operable gastric cancer: results of the Dutch randomised FAMTX trial. The Dutch Gastric Cancer Group (DGCG)[J]. Eur J Cancer, 1999; 35(4): 558-562.
19. Fujii M, Kosaki G, Tsuchiya S, et al. Randomized trial of preoperative adjuvant chemotherapy using oral 5-FU in operable gastric cancer [A]. Proc Am Soc Clin Oncol, 1999; 18: Abstract 1045.
20. Kang YK, Choi DW, Im YH, et al. A phase Ⅲ randomized comparison of neoadjuvant chemotherapy followed by surgery versus surgery for locally advanced stomach cancer [A]. Proc Am Soc Clin Oncol, 1996; 15: Abstract 503.
21. Allum W, Cunningham D, Weeden S, et al. Perioperative chemotherapy in operable gastric and lower oesophageal cancer: A randomised, controlled trial (the MAGIC trial, ISRCTN 93793971) [A]. Proc Am Soc Clin Oncol, 2003; 22: Abstract 998.
22. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy in operable gastric and lower oesophageal cancer: final results of a randomised, controlled trial (the MAGIC trial, ISRCTN 93793971) [J]. J Clin Oncol (Meeting Abstracts), 2005; 23(16S): 4001.
23. Boige V, Pignon J, Saint-Aubert B, et al. Final results of a randomized trial comparing preoperative 5-fluorouracil (F)/cisplatin (P) to surgery alone in adenocarcinoma of stomach and lower esophagus (ASLE): FNLCC ACCORD07-FFCD 9703 trial[J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4510.
24. Zhang ZX, Gu XZ, Yin WB, et al. Randomized clinical trial on the combination of preoperative irradiation and surgery in the treatment of adenocarcinoma of gastric cardia (AGC)—report on 370 patients [J]. Int J Radiat Oncol Biol Phys, 1998; 42(5): 929-934.
25. Stahl M, Walz MK, Stuschke M, et al. Preoperative chemotherapy (CTX) versus preoperative chemoradiotherapy (CRTX) in locally advanced esophagogastric adenocarcinomas: First results of a randomized phase Ⅲ trial[J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4511.
26. Nio Y, Koike M, Omori H, et al. A randomized consent design trial of neoadjuvant chemotherapy with tegafur plus uracil (UFT) for gastric cancer—a single institute study[J]. Anticancer Res, 2004; 24(3b): 1879-1887.
27. Hartgrink HH, van de Velde CJ, Putter H, et al. Neo-adjuvant chemotherapy for operable gastric cancer: long term results of the Dutch randomised FAMTX trial[J]. Eur J Surg Oncol, 2004; 30(6): 643-649.
28. Forshaw MJ, Gossage JA, Chrystal K, et al. Neoadjuvant chemotherapy for locally advanced carcinoma of the lower oesophagus and oesophago-gastric junction[J]. Eur J Surg Oncol, 2006; 32(10): 1114-1118.
29. Cascinu S, Scartozzi M, Labianca R, et al. High curative resection rate with weekly cisplatin, 5-fluorouracil, epidoxorubicin, 6S-leucovorin, glutathione, and filgastrim in patients with locally advanced, unresectable gastric cancer: a report from the Italian Group for the Study of Digestive Tract Cancer (GISCAD) [J]. Br J Cancer, 2004; 90(8): 1521-1525.
30. Yabusaki H, Nashimoto A, Tanaka O. Evaluation of TS-1 combined with cisplatin for neoadjuvant chemotherapy in patients with advanced gastric cancer[J]. Gan To Kagaku Ryoho, 2003; 30(12): 1933-1940.
31. Sym S, Chang H, Ryu M, et al. A phase Ⅱ study of neoadjuvant chemotherapy with docetaxel, capecitabine and cisplatin (DXP) in patients with advanced unresectable or intra-abdominal metastatic gastric cancer[J]. J Clin Oncol(Meeting Abstracts), 2007; 25(18S): 4640.
32. Moon H, Ji JF, Wu AW, et al. Oxaliplatin + 5-fluorouracil/leucovorin (FOLFOX7) as neoadjuvant plus adjuvant treatment versus adjuvant alone in locally advanced resectable gastric cancer: BJSA-01 study design and interim results [A/OL]. 2007 Gastrointestinal Cancers Symposium: Abstract 39.
33. Hfler H, Langer R, Ott K, et al. Prediction of response to neoadjuvant chemotherapy in carcinomas of the upper gastrointestinal tract[J]. Recent Results Cancer Res, 2007; 176: 33-36.
34. Im S, Kim S, Kim J, et al. A phase Ⅱ trial of perioperative chemotherapy with folinic acid, 5-fluorouracil, and oxaliplatin in potentially resectable gastric cancer with regional lymph node metastasis [J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4602.
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《中國普外基礎與臨床雜志》

潛在可切除性胃癌的新輔助化療

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《中國普外基礎與臨床雜志》

潛在可切除性胃癌的新輔助化療

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

摘要全文圖表視頻參考文獻施引文獻補充材料