胃癌诊疗的热点和问题  

The foci and problems in diagnosis and treatment of gastric cancer

作　　者：符涛[1] 步召德[1] 李子禹[1] 武爱文[1] 张霁[1] 吴晓江[1] 张连海[1] 季鑫[1] 季加孚[1] 

机构地区：[1]北京大学临床肿瘤学院,北京市肿瘤防治研究所,恶性肿瘤发病机制及转化研究教育部重点实验室,北京肿瘤医院胃肠肿瘤中心,北京市100142

出　　处：《中国肿瘤临床》2016年第1期35-41,共7页Chinese Journal of Clinical Oncology

摘　　要：我国是胃癌高发地区,发病率与死亡率在恶性肿瘤中均位居前列,受区域发展水平的制约,我国的胃癌诊治条件尚不能够完全满足众多病患的需求,面临着十分严峻的抗击胃癌形势。多学科、个体化、规范化治疗是胃癌诊治的发展趋势,目前有关胃癌的热点及争议有很多,胃癌诊治问题的解决有赖于循证医学研究的进一步发展。本文从胃癌临床分期、腹腔镜手术技术、早期胃癌的诊治、晚期胃癌转化治疗、食管胃结合部癌的治疗策略、快速康复外科、基础医学转化研究及胃癌临床试验等方面进行综述,系统地概括当前胃癌诊疗的热点和问题,希望能对广大同道起到一定的参考作用。Objective： To investigate the efficacy, safety, and overall survival of advanced upper gastric cancer patients who received preoperative chemoradiation therapy. Methods： A total of 62 patients who received preoperative chemotherapy or chemoradiationtherapy in the Department of Gastrointestinal Surgery of Beijing Cancer Hospital ＆ institute were retrospectively observed to determine the efficacy and safety and to perform survival analysis of preoperative chemoradiation therapy. Results： Results of the postoperative pathology showed that the number of patients with 1-4 and N3 stages was significantly lower in the preoperative chemoradiation therapy group than in the preoperative chemotherapy group （P〈0.05）. In addition, the differences between the two groups in terms of safety and toxicity were not significant （P≥0.05）. Analysis also showed that the differences between the two groups in terms of survival were not significant （P≥0.05）. Conclusion： Patients with advanced upper gastric cancer can gain a potential survival advantage from preoperative chemoradiation therapy. Compared with preoperative chemotherapy, preoperative chemoradiation therapy was performed without increased risk of toxicity and insecurity. Preoperative chemoradiation therapy can also improve the local control ratio, especially the control ratio of lymphatic metastasis. However, the final results of survival analysis depend on long-term follow-up of patients.

关 键 词：胃上部癌 术前放化疗 有效性 安全性 

分 类 号：R735.2[医药卫生—肿瘤]