Heo-adjuvant and adjuvant chemotherapy off gastric cancer
Heo-adjuvant and adjuvant chemotherapy off gastric cancer
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DOI：
10.1093/annonc/mdm239
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发表时间：
2007-01-01
影响因子：
50.5
通讯作者：
Orditura, M.
中科院分区：
文献类型：
--
作者：
De Vita, F.;Giuliani, F.;Orditura, M.
胃癌仍然是一个主要的健康问题和癌症死亡的主要原因，尽管在世界范围内的发病率下降。手术是局部胃癌的主要治疗手段。然而，在西方国家，在切除术时，大多数患者预计有区域淋巴结受累，预后不良的影响。为了改善这些结果，在辅助或新辅助治疗环境中进行了不同的试验。已经进行了许多辅助治疗的III期试验;然而，术后治疗方式并没有被证明上级单独的术后观察。因此，目前应将常规使用辅助治疗视为一种研究方法。需要改进临床试验设计，采用标准化的手术技术，并纳入更新的活性药物。相反，新辅助化疗已显示出有希望的结果;如英国医学研究理事会辅助胃灌注化疗试验的最终结果所示。
Gastric cancer is still a major health problem and a leading cause of cancer mortality despite a worldwide decline in incidence. Surgery is the primary curative treatment of locoregional gastric cancer. In Western countries, however, at the time of resection, most patients are expected to have regional lymph node involvement with poor prognostic implications. To improve these results, different trials have been carried out in the adjuvant or neo-adjuvant setting. Many phase III trials of adjuvant therapy have been conducted; however, postoperative treatment modalities have not proven to be superior to postsurgical observation alone. Therefore, at present the routine use of adjuvant therapy should be regarded as an investigational approach. Improved clinical trial designs with standardized surgical techniques and the incorporation of newer active drugs are needed. On the contrary, neo-adjuvant chemotherapy has shown promising results; as suggested by the final results of UK Medical Research Council Adjuvant Gastric Infusional Chemotherapy trial.