Between evidence and new perspectives on the current state of the multimodal approach to gastric cancer:Is there still a role for radiation therapy?  

作　　者：Linda Agolli Luca Nicosia 

机构地区：[1]Department of Radiation Oncology,Faculty of Medicine and University Hospital Carl Gustav Carus,Technische Universit?t Dresden [2]Department of Radiation Oncology,Sant'Andrea Hospital,Sapienza University of Rome

出　　处：《World Journal of Gastrointestinal Oncology》2018年第9期271-281,共11页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：In patients affected by gastric cancer(GC), especially those in advanced stage, the multidisciplinary app-roach of treatment is fundamental to obtain a good disease control and quality of life. Although many chemotherapeutics in combination to radiotherapy are adopted in the peri- or postoperative setting, the most optimal timing, regimens and doses remains con-troversial. In the era of radical surgery performed with D2-lymphadenectomy, the role of radiation therapy remains to be better defined. Categories of patients, who could benefit more from an intensified local trea-tment rather than more toxic systemic therapy, are still under investigation. Evidence and recent updates of the randomized trials, meta-analysis and prospective trials show that the postoperative radiotherapy plays a fundamental role in reducing the loco-regional recurrence and in turn the disease-free survival in operable advanced GC patients, also after a well performed D2 surgery. Therapeutic decisions should be taken considering the individual patients, but the multimodal approach is necessary to guarantee a longer survival and a good quality of life. Ongoing randomized trials could better define the timing and the combination of radiotherapy and systemic therapy.In patients affected by gastric cancer(GC), especially those in advanced stage, the multidisciplinary app-roach of treatment is fundamental to obtain a good disease control and quality of life. Although many chemotherapeutics in combination to radiotherapy are adopted in the peri- or postoperative setting, the most optimal timing, regimens and doses remains con-troversial. In the era of radical surgery performed with D2-lymphadenectomy, the role of radiation therapy remains to be better defined. Categories of patients, who could benefit more from an intensified local trea-tment rather than more toxic systemic therapy, are still under investigation. Evidence and recent updates of the randomized trials, meta-analysis and prospective trials show that the postoperative radiotherapy plays a fundamental role in reducing the loco-regional recurrence and in turn the disease-free survival in operable advanced GC patients, also after a well performed D2 surgery. Therapeutic decisions should be taken considering the individual patients, but the multimodal approach is necessary to guarantee a longer survival and a good quality of life. Ongoing randomized trials could better define the timing and the combination of radiotherapy and systemic therapy.

关 键 词：Adjuvant chemoradiation Locally advanced Perioperative chemotherapy Gastric cancer Combined treatment 

分 类 号：R[医药卫生]