• 川北醫(yī)學(xué)院附屬第二醫(yī)院普外二科,綿陽四O四醫(yī)院(四川綿陽621000);

目的　介紹進(jìn)展期胃癌多模式治療的研究進(jìn)展。方法　收集國內(nèi)、外近年來有關(guān)進(jìn)展期胃癌多模式治療的研究進(jìn)展文獻(xiàn)并作一綜述。結(jié)果　多模式治療能提高可切除進(jìn)展期胃癌患者R0 切除率,降低術(shù)后死亡率,延長總生存期,提高生活質(zhì)量。結(jié)論　進(jìn)展期胃癌多模式治療的應(yīng)用將具有廣闊的發(fā)展前景。

引用本文： 何運(yùn)勝,姜淮蕪. 進(jìn)展期胃癌多模式治療的研究進(jìn)展. 中國普外基礎(chǔ)與臨床雜志, 2008, 15(1): 31-35. doi: 復(fù)制

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1. <>[1]Higuchi K,Phan A,Ajani JA.Gastric cancer:advances in adjuvant and adjunct therapy[J].Curr Treat Options Oncol,2003; 4(5)∶413.
2. 劉福坤,姚學(xué)權(quán).胃癌的新輔助化療[J].中國普外基礎(chǔ)與臨床雜志,2006; 13(1)∶18.
3. Cheong JH,Shen JY,Song CS,et al.Early postoperative intraperitoneal chemotherapy following cytoreductive surgery in patients with very advanced gastric cancer[J].Ann Surg Oncol,2007; 14(1)∶61.
4. 詹文華.胃癌手術(shù)前化療的研究現(xiàn)狀[J].中華胃腸外科雜志,2005; 8(5)∶471.
5. Frei E 3rd.Clinical cancer research:an embattled species[J].Cancer,1982; 50(10)∶1979.
6. Cunningham D,Allum WH,Stenning SP,et al.Perioperative chemotherapy in operable gastric and lower oesophageal cancer:final results of a randomized controlled trial (the MAGIC trial,ISRCTN 93793971)[J].Proc Am Soc Clin Oncol,2005; 23∶308s.
7. 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.
8. Yamaguchi K,Nakagawa S,Yabusaki H,et al.A case of advanced gastric cancer responding remarkably to paclitaxel + low-dose FP therapy in a neoadjuvant setting[J].Gan To Kagaku Ryoho,2006; 33(8)∶1163.
9. Persiani R,D’Ugo D,Biondi A,et al.T-downstaging after neoadjuvant chemotherapy in locally advanced gastric carcinoma[J].Suppl Tumori,2005; 4(3)∶S88.
10. Newman E,Marcus SG,Potmesil M,et al.Neoadjuvant ch-emotherapy with CPT-11 and cisplatin downstages locally advanced gastric cancer[J].J Gastrointest Surg,2002; 6(2)∶212.
11. Lowy AM,Mansfield PF,Leach SD,et al.Response to neoadjuvant chemotherapy best predicts survival after curative resection of gastric cancer[J].Ann Surg,1999; 229(3)∶303.
12. Koizumi W,Kurihara M,Nakano S,et al.Phase Ⅱ study of S-1,a novel oral derivative of 5-fluorouracil,in advanced gastric cancer.For the S-1 Cooperative Gastric Cancer Study Group[J].Oncology,2000; 58(3)∶191.
13. Nakano K,Koizumi H,Okugawa K,et al.Evaluation of pre-operative administration of TS-1 in patients with advanced gastric or colorectal cancer--estimation of pathological effectiveness for postoperative adjuvant chemotherapy with TS-1[J].Gan To Kagaku Ryoho,2005; 32(3)∶329.
14. Yoshida K,Ishikawa H,Sumida Y,et al.A case of N3 gastric cancer successfully treated by TS-1 followed by curative resection[J].Gan To Kagaku Ryoho,2006; 33(9)∶1321.
15. Tsuchiya Y,Nashimoto A,Nakagawa S,et al.Advanced gastric cancer responding to pathological CR after neoadjuvant TS-1 combined with CDDP therapy--report of a case[J].Gan To Kagaku Ryoho,2006; 33(6)∶807.
16. Nomura M,Inoue Y,Fujita S,et al.A case of gastric adenosquamous carcinoma with abdominal paraaortic lymph node metastases successfully treated by TS-1 plus CDDP neoadjuvant chemotherapy[J].Gan To Kagaku Ryoho,2006; 33(1)∶99.
17. Mori S,Kishimoto H,Tauchi K,et al.Histological complete response in advanced gastric cancer after 2 weeks of S-1 administration as neoadjuvant chemotherapy[J].Gastric Cancer,2006; 9(2)∶136.
18. Willett CG.Results of radiation therapy in gastric cancer[J].Semin Radiat Oncol,2002; 12(2)∶170.
19. Klautke G,Foitzik T,Ludwig K,et al.Neoadjuvant radiochemotherapy in locally advanced gastric carcinoma[J].Strahlenther Onkol,2004; 180(11)∶695.
20. Ajani JA,Mansfield PF,Janjan N,et al.Multi-institutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma[J].J Clin Oncol,2004; 22(14)∶2774.
21. Mauera M,Harafd C,Ferguson K,et al.Docetaxel-based combined modality therapy for locally advance carcinoma of the esophagus and gastric carcinoma[J].Proc Am Soc Clin Oncol,2000; 19(6)∶954.
22. Roth AD,Allal AS,Brundler MA,et al.Neoadjuvant radiochemotherapy for locally advanced gastric cancer:a phase Ⅰ-Ⅱ study[J].Ann Oncol,2003; 14(1)∶110.
23. Lowy AM,Feig BW,Janjan N,et al.A pilot study of preoperative chemoradiotherapy for resectable gastric cancer[J].Ann Surg Oncol,2001; 8(6)∶519.
24. Shchepotin IB,Chorny V,Hanfelt J,et al.Palliative superselective intra-arterial chemotherapy for advanced nonresectable gastric cancer[J].J Gastrointest Surg,1999; 3(4)∶426.
25. 吳鵬,朱正綱,葉正寶,等.5-氟尿嘧啶-2′-脫氧核苷經(jīng)胃左動(dòng)脈介入灌注后的藥代動(dòng)力學(xué)實(shí)驗(yàn)研究[J].外科理論與實(shí)踐,2004; 9(2)∶135.
26. 蒲青凡,孫碎康,劉占培,等.術(shù)前胃動(dòng)脈化療栓塞對(duì)胃癌淋巴結(jié)轉(zhuǎn)移灶癌細(xì)胞凋亡的影響[J].中國普外基礎(chǔ)與臨床雜志,2006; 13(4)∶427.
27. 王舒寶,王俊.胃癌復(fù)發(fā)與轉(zhuǎn)移的有關(guān)問題及綜合治療[J].中國普外基礎(chǔ)與臨床雜志,2006; 13(1)∶9.
28. 孫建軍,馬建芳,陳少華.動(dòng)脈灌注化療聯(lián)合栓塞治療晚期胃癌[J].江西醫(yī)學(xué)院學(xué)報(bào),2006; 46(4)∶138.
29. 時(shí)桂蘭,邢海鳳,劉文昌,等.胃癌術(shù)前介入治療的臨床意義[J].現(xiàn)代醫(yī)用影像學(xué),2005; 14(4)∶165.
30. Pestieau SR,Sugarbaker PH.Treatment of primary colon cancer with peritoneal carcinomatosis:comparison of concomitant vs.delayed management[J].Dis Colon Rectum,2000; 43(10)∶1341.
31. Brenner B,Shah MA,Karpeh MS,et al.A phase Ⅱ trial of neoadjuvant cisplatin-fluorouracil followed by postoperative intraperitoneal floxuridine-leucovorin in patients with locally advanced gastric cancer[J].Ann Oncol,2006; 17(9)∶1404.
32. Ceelen WP,Hesse U,de Hemptinne B,et al.Hyperthermic intraperitoneal chemoperfusion in the treatment of locally advanced intra-abdominal cancer[J].Br J Surg,2000; 87(8)∶1006.
33. Pestieau SR,Schnake KJ,Stuart OA,et al.Impact of carrier solutions on pharmacokinetics of intraperitoneal chemotherapy[J].Cancer Chemother Pharmacol,2001; 47(3)∶269.
34. Jansen M,Büchin P,Dreuw B,et al.Prognostic factors for development of peritoneal carcinosis in stomach carcinoma[J].Chirurgeon,2001; 72(5)∶561.
35. Newman E,Potmesil M,Ryan T,et al.Neoadjuvant chemotherapy,surgery,and adjuvant intraperitoneal chemotherapy in patients with locally advanced gastric or gastroesophageal junction carcinoma:a phase Ⅱ study[J].Semin Oncol,2005; 32(6 Suppl 9)∶S97.
36. 梁寒,王仆,王曉娜,等.活性碳吸附絲裂霉素C腹腔化療預(yù)防進(jìn)展期胃癌術(shù)后復(fù)發(fā)[J].中華外科雜志,2003; 41(4)∶274.
37. 李琛.腹腔溫?zé)峄煹呐R床意義及其對(duì)機(jī)體生理功能的影響[J].外科理論與實(shí)踐,1998; 3(1)∶48.
38. Roviello F,Marrelli D,Neri A,et al.Treatment of peritoneal carcinomatosis by cytoreductive surgery and intraperitoneal hyperthermic chemoperfusion (IHCP):postoperative outcome and risk factors for morbidity[J].World J Surg,2006; 30(11)∶2033.
39. Marutsuka T,Shimada S,Shiomori K,et al.Mechanisms of peritoneal metastasis after operation for non-serosa-invasive gastric carcinoma:an ultrarapid detection system for intraperitoneal free cancer cells and a prophylactic strategy for peritoneal metastasis[J].Clin Cancer Res,2003; 9(2)∶678.
40. 何濤,楊志明,伍曉汀.胃癌腹膜播散轉(zhuǎn)移機(jī)理的研究進(jìn)展[J].中國普外基礎(chǔ)與臨床雜志,2005; 12(1)∶45.
41. De Roover A,Detroz B,Detry O,et al.Adjuvant hyperthermic intraperitoneal perioperative chemotherapy (HIPEC) associated with curative surgery for locally advanced gastric carcinoma.An initial experience[J].Acta Chir Belg,2006; 106(3)∶297.
42. Yonemura Y,de Aretxabala X,Fujimura T,et al.Intraoperative chemohyperthermic peritoneal perfusion as an adjuvant to gastric cancer:final results of a randomized controlled study[J].Hepatogastroenterology,2001; 48(42)∶1776.
43. 朱正綱,湯睿.術(shù)中腹腔內(nèi)溫?zé)峄煂?duì)進(jìn)展期胃癌的臨床療效研究[J].中華胃腸外科雜志,2006; 9(1)∶26.
44. Janunger KG,Hafstrom L,Glimelius B.Chemotherapy in gastric cancer:a review and updated meta-analysis[J].Eur J Surg,2002; 168(11)∶597.
45. Valentini V,Cellini F,D’Angelillo RM.Combined treatments in gastric cancer:radiotherapy[J].Suppl Tumori,2003; 2(5)∶S39.
46. 季加孚主編.胃癌防治新觀念[M].北京:人民軍醫(yī)出版社,2007∶1～4.
47. Cunliffe WJ,Sugarbaker PH.Gastrointestinal malignancy:rationale for adjuvant therapy using early postoperative intraperitoneal chemotherapy[J].Br J Surg,1989; 76(10)∶1082.
48. van Ruth S,Verwaal VJ,Hart AA,et al.Heat penetration in locally applied hyperthermia in the abdomen during intra-operative hyperthermic intraperitoneal chemotherapy[J].Anticancer Res,2003; 23(2B)∶1501.
  1. 1. <>[1]Higuchi K,Phan A,Ajani JA.Gastric cancer:advances in adjuvant and adjunct therapy[J].Curr Treat Options Oncol,2003; 4(5)∶413.
  2. 2. 劉福坤,姚學(xué)權(quán).胃癌的新輔助化療[J].中國普外基礎(chǔ)與臨床雜志,2006; 13(1)∶18.
  3. 3. Cheong JH,Shen JY,Song CS,et al.Early postoperative intraperitoneal chemotherapy following cytoreductive surgery in patients with very advanced gastric cancer[J].Ann Surg Oncol,2007; 14(1)∶61.
  4. 4. 詹文華.胃癌手術(shù)前化療的研究現(xiàn)狀[J].中華胃腸外科雜志,2005; 8(5)∶471.
  5. 5. Frei E 3rd.Clinical cancer research:an embattled species[J].Cancer,1982; 50(10)∶1979.
  6. 6. Cunningham D,Allum WH,Stenning SP,et al.Perioperative chemotherapy in operable gastric and lower oesophageal cancer:final results of a randomized controlled trial (the MAGIC trial,ISRCTN 93793971)[J].Proc Am Soc Clin Oncol,2005; 23∶308s.
  7. 7. 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.
  8. 8. Yamaguchi K,Nakagawa S,Yabusaki H,et al.A case of advanced gastric cancer responding remarkably to paclitaxel + low-dose FP therapy in a neoadjuvant setting[J].Gan To Kagaku Ryoho,2006; 33(8)∶1163.
  9. 9. Persiani R,D’Ugo D,Biondi A,et al.T-downstaging after neoadjuvant chemotherapy in locally advanced gastric carcinoma[J].Suppl Tumori,2005; 4(3)∶S88.
  10. 10. Newman E,Marcus SG,Potmesil M,et al.Neoadjuvant ch-emotherapy with CPT-11 and cisplatin downstages locally advanced gastric cancer[J].J Gastrointest Surg,2002; 6(2)∶212.
  11. 11. Lowy AM,Mansfield PF,Leach SD,et al.Response to neoadjuvant chemotherapy best predicts survival after curative resection of gastric cancer[J].Ann Surg,1999; 229(3)∶303.
  12. 12. Koizumi W,Kurihara M,Nakano S,et al.Phase Ⅱ study of S-1,a novel oral derivative of 5-fluorouracil,in advanced gastric cancer.For the S-1 Cooperative Gastric Cancer Study Group[J].Oncology,2000; 58(3)∶191.
  13. 13. Nakano K,Koizumi H,Okugawa K,et al.Evaluation of pre-operative administration of TS-1 in patients with advanced gastric or colorectal cancer--estimation of pathological effectiveness for postoperative adjuvant chemotherapy with TS-1[J].Gan To Kagaku Ryoho,2005; 32(3)∶329.
  14. 14. Yoshida K,Ishikawa H,Sumida Y,et al.A case of N3 gastric cancer successfully treated by TS-1 followed by curative resection[J].Gan To Kagaku Ryoho,2006; 33(9)∶1321.
  15. 15. Tsuchiya Y,Nashimoto A,Nakagawa S,et al.Advanced gastric cancer responding to pathological CR after neoadjuvant TS-1 combined with CDDP therapy--report of a case[J].Gan To Kagaku Ryoho,2006; 33(6)∶807.
  16. 16. Nomura M,Inoue Y,Fujita S,et al.A case of gastric adenosquamous carcinoma with abdominal paraaortic lymph node metastases successfully treated by TS-1 plus CDDP neoadjuvant chemotherapy[J].Gan To Kagaku Ryoho,2006; 33(1)∶99.
  17. 17. Mori S,Kishimoto H,Tauchi K,et al.Histological complete response in advanced gastric cancer after 2 weeks of S-1 administration as neoadjuvant chemotherapy[J].Gastric Cancer,2006; 9(2)∶136.
  18. 18. Willett CG.Results of radiation therapy in gastric cancer[J].Semin Radiat Oncol,2002; 12(2)∶170.
  19. 19. Klautke G,Foitzik T,Ludwig K,et al.Neoadjuvant radiochemotherapy in locally advanced gastric carcinoma[J].Strahlenther Onkol,2004; 180(11)∶695.
  20. 20. Ajani JA,Mansfield PF,Janjan N,et al.Multi-institutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma[J].J Clin Oncol,2004; 22(14)∶2774.
  21. 21. Mauera M,Harafd C,Ferguson K,et al.Docetaxel-based combined modality therapy for locally advance carcinoma of the esophagus and gastric carcinoma[J].Proc Am Soc Clin Oncol,2000; 19(6)∶954.
  22. 22. Roth AD,Allal AS,Brundler MA,et al.Neoadjuvant radiochemotherapy for locally advanced gastric cancer:a phase Ⅰ-Ⅱ study[J].Ann Oncol,2003; 14(1)∶110.
  23. 23. Lowy AM,Feig BW,Janjan N,et al.A pilot study of preoperative chemoradiotherapy for resectable gastric cancer[J].Ann Surg Oncol,2001; 8(6)∶519.
  24. 24. Shchepotin IB,Chorny V,Hanfelt J,et al.Palliative superselective intra-arterial chemotherapy for advanced nonresectable gastric cancer[J].J Gastrointest Surg,1999; 3(4)∶426.
  25. 25. 吳鵬,朱正綱,葉正寶,等.5-氟尿嘧啶-2′-脫氧核苷經(jīng)胃左動(dòng)脈介入灌注后的藥代動(dòng)力學(xué)實(shí)驗(yàn)研究[J].外科理論與實(shí)踐,2004; 9(2)∶135.
  26. 26. 蒲青凡,孫碎康,劉占培,等.術(shù)前胃動(dòng)脈化療栓塞對(duì)胃癌淋巴結(jié)轉(zhuǎn)移灶癌細(xì)胞凋亡的影響[J].中國普外基礎(chǔ)與臨床雜志,2006; 13(4)∶427.
  27. 27. 王舒寶,王俊.胃癌復(fù)發(fā)與轉(zhuǎn)移的有關(guān)問題及綜合治療[J].中國普外基礎(chǔ)與臨床雜志,2006; 13(1)∶9.
  28. 28. 孫建軍,馬建芳,陳少華.動(dòng)脈灌注化療聯(lián)合栓塞治療晚期胃癌[J].江西醫(yī)學(xué)院學(xué)報(bào),2006; 46(4)∶138.
  29. 29. 時(shí)桂蘭,邢海鳳,劉文昌,等.胃癌術(shù)前介入治療的臨床意義[J].現(xiàn)代醫(yī)用影像學(xué),2005; 14(4)∶165.
  30. 30. Pestieau SR,Sugarbaker PH.Treatment of primary colon cancer with peritoneal carcinomatosis:comparison of concomitant vs.delayed management[J].Dis Colon Rectum,2000; 43(10)∶1341.
  31. 31. Brenner B,Shah MA,Karpeh MS,et al.A phase Ⅱ trial of neoadjuvant cisplatin-fluorouracil followed by postoperative intraperitoneal floxuridine-leucovorin in patients with locally advanced gastric cancer[J].Ann Oncol,2006; 17(9)∶1404.
  32. 32. Ceelen WP,Hesse U,de Hemptinne B,et al.Hyperthermic intraperitoneal chemoperfusion in the treatment of locally advanced intra-abdominal cancer[J].Br J Surg,2000; 87(8)∶1006.
  33. 33. Pestieau SR,Schnake KJ,Stuart OA,et al.Impact of carrier solutions on pharmacokinetics of intraperitoneal chemotherapy[J].Cancer Chemother Pharmacol,2001; 47(3)∶269.
  34. 34. Jansen M,Büchin P,Dreuw B,et al.Prognostic factors for development of peritoneal carcinosis in stomach carcinoma[J].Chirurgeon,2001; 72(5)∶561.
  35. 35. Newman E,Potmesil M,Ryan T,et al.Neoadjuvant chemotherapy,surgery,and adjuvant intraperitoneal chemotherapy in patients with locally advanced gastric or gastroesophageal junction carcinoma:a phase Ⅱ study[J].Semin Oncol,2005; 32(6 Suppl 9)∶S97.
  36. 36. 梁寒,王仆,王曉娜,等.活性碳吸附絲裂霉素C腹腔化療預(yù)防進(jìn)展期胃癌術(shù)后復(fù)發(fā)[J].中華外科雜志,2003; 41(4)∶274.
  37. 37. 李琛.腹腔溫?zé)峄煹呐R床意義及其對(duì)機(jī)體生理功能的影響[J].外科理論與實(shí)踐,1998; 3(1)∶48.
  38. 38. Roviello F,Marrelli D,Neri A,et al.Treatment of peritoneal carcinomatosis by cytoreductive surgery and intraperitoneal hyperthermic chemoperfusion (IHCP):postoperative outcome and risk factors for morbidity[J].World J Surg,2006; 30(11)∶2033.
  39. 39. Marutsuka T,Shimada S,Shiomori K,et al.Mechanisms of peritoneal metastasis after operation for non-serosa-invasive gastric carcinoma:an ultrarapid detection system for intraperitoneal free cancer cells and a prophylactic strategy for peritoneal metastasis[J].Clin Cancer Res,2003; 9(2)∶678.
  40. 40. 何濤,楊志明,伍曉汀.胃癌腹膜播散轉(zhuǎn)移機(jī)理的研究進(jìn)展[J].中國普外基礎(chǔ)與臨床雜志,2005; 12(1)∶45.
  41. 41. De Roover A,Detroz B,Detry O,et al.Adjuvant hyperthermic intraperitoneal perioperative chemotherapy (HIPEC) associated with curative surgery for locally advanced gastric carcinoma.An initial experience[J].Acta Chir Belg,2006; 106(3)∶297.
  42. 42. Yonemura Y,de Aretxabala X,Fujimura T,et al.Intraoperative chemohyperthermic peritoneal perfusion as an adjuvant to gastric cancer:final results of a randomized controlled study[J].Hepatogastroenterology,2001; 48(42)∶1776.
  43. 43. 朱正綱,湯睿.術(shù)中腹腔內(nèi)溫?zé)峄煂?duì)進(jìn)展期胃癌的臨床療效研究[J].中華胃腸外科雜志,2006; 9(1)∶26.
  44. 44. Janunger KG,Hafstrom L,Glimelius B.Chemotherapy in gastric cancer:a review and updated meta-analysis[J].Eur J Surg,2002; 168(11)∶597.
  45. 45. Valentini V,Cellini F,D’Angelillo RM.Combined treatments in gastric cancer:radiotherapy[J].Suppl Tumori,2003; 2(5)∶S39.
  46. 46. 季加孚主編.胃癌防治新觀念[M].北京:人民軍醫(yī)出版社,2007∶1～4.
  47. 47. Cunliffe WJ,Sugarbaker PH.Gastrointestinal malignancy:rationale for adjuvant therapy using early postoperative intraperitoneal chemotherapy[J].Br J Surg,1989; 76(10)∶1082.
  48. 48. van Ruth S,Verwaal VJ,Hart AA,et al.Heat penetration in locally applied hyperthermia in the abdomen during intra-operative hyperthermic intraperitoneal chemotherapy[J].Anticancer Res,2003; 23(2B)∶1501.