摘要
本文主要综述进展期胃癌的手术治疗、化学治疗及放射治疗的现状和进展。对于Ⅱ/Ⅲ期的胃癌主要是以D2手术根治为主,并辅以术中的热疗。对于完整的术前分期检查,使得ⅢB/Ⅳ期的患者予以新辅助化疗后再行手术,这部分手术再切除,可提高胃癌患者的生存率,亦能改善生活质量。术后的辅助治疗,在原有的氟尿嘧啶、多柔比星(阿霉素)、顺铂治疗方案的基础上,氟尿嘧啶与奥沙利铂(乐沙定)、氟尿嘧啶、顺铂与紫杉醇组合及顺铂加CPT-11组成的方案有效率均有不同程度的提高。术后的放化疗结合也在研究探讨之中。
The current status and important advances in multi-disciplinary treatment for advanced gastric cancer, including surgery, chemotherapy and radiotherapy, were reviewed in this article. An operative scheme based on the stage and biologic behavior of the tumor is adopted with the D2 procedure combined with intraoperative peritoneal hyperthermic chemotherapy （IPHC） for stage Ⅱ and Ⅲ patients. Accurate preoperative staging is of utmost importance in making an appropriate therapeutic strategy. For patients with stage m R and IV gastric cancer, neo-adjuvant chemotherapy followed by cyto-reductive surgery, is helpful to prolong survival and improve the quality of life. Besides the 5-FU, eisplatin and doxorubicin based regimen, combination regimens employing newer generation cytotoxic agents including oxaliplatin, irinotecan, taxanes provided more promising efficacy. Postoperative chemo-radiotherapy is presently under investigation.
出处
《中国癌症杂志》
CAS
CSCD
2006年第10期771-774,共4页
China Oncology
作者简介
叶正宝。上海交通大学医学院附属瑞金医院肿瘤放化疗科副主任医师。中国抗癌协会胃癌专业委员会委员，上海抗癌协会胃肠肿瘤专业委员会委员，上海抗癌协会理事，上海医学会肿瘤学会委员，上海肿瘤姑息治疗委员会委员，《中国康复杂志》编委，《中华现代中西医杂志》编委，《中华现代内科学杂志》常务编委。迄今发表学术论文30余篇，参著《胃肠道肿瘤外科综合治疗新技术》及《胃病诊治进展》。目前参与胃肠道肿瘤的综合治疗、胃肠道肿瘤患者化疗前后免疫状态的监测、胃癌新辅助化疗及其机制的，临床和基础研究等多项市局级课题研究。
通讯作者：朱正纲，E-mail：zzg1954@hotmail．com
