切换至 "中华医学电子期刊资源库"

中华普外科手术学杂志(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 451 -455. doi: 10.3877/cma.j.issn.1674-3946.2023.04.026

综述

晚期胃癌治疗方法的研究进展和挑战
徐瑜杰, 赵国栋()   
  1. 570208 海南海口,海口市人民医院胃肠外科
  • 收稿日期:2023-03-02 出版日期:2023-08-26
  • 通信作者: 赵国栋

Advances and challenges in the treatment of advanced gastric cancer

Yujie Xu, Guodong Zhao()   

  1. Department of Gastroenterology, Haikou People’s Hospital, Haikou Hainan Province 570208, China
  • Received:2023-03-02 Published:2023-08-26
  • Corresponding author: Guodong Zhao
  • Supported by:
    Natural Science Foundation of Hainan Province(823RC609)
引用本文:

徐瑜杰, 赵国栋. 晚期胃癌治疗方法的研究进展和挑战[J/OL]. 中华普外科手术学杂志(电子版), 2023, 17(04): 451-455.

Yujie Xu, Guodong Zhao. Advances and challenges in the treatment of advanced gastric cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(04): 451-455.

胃癌是一种最常见的消化系统恶性肿瘤。目前,外科手术已成为根治胃癌的主要方法。随着外科技术的不断进步以及放疗、化疗、新的辅助疗法等手段的应用,早期胃癌患者5年生存率超过95%。但由于早期诊断率较低,大部分患者在确诊时已有较严重的病变,因此错过了最佳的治疗时机。目前,新辅助放化疗、分子靶向及免疫疗法是晚期胃癌的主要治疗手段。本文对近年来晚期胃癌的一些常用治疗手段进行了综述,并对其治疗进展进行了较详尽的论述。只有把临床研究与临床实践结合起来,才能使晚期胃癌患者得到有效的治疗;同时,重视患者的个体特征,合理用药,制订全面的治疗方案,提升治疗效果。

Gastric cancer is one of the most common malignant tumors of the digestive system. At present,surgery has become the main method of radical treatment of gastric cancer. With the continuous progress of surgical techniques and the application of radiotherapy,chemotherapy and new adjuvant therapies,the 5-year survival rate of early gastric cancer patients is more than 95%. However,due to the low early diagnosis rate,most patients have more serious lesions at the time of diagnosis,so the best treatment opportunity is missed. At present,neoadjuvant chemoradiotherapy,molecular targeting and immunotherapy are the main treatments for advanced gastric cancer. In this paper,some commonly used treatment methods for advanced gastric cancer in recent years are reviewed,and the progress of treatment is discussed in detail. Only by combining clinical research with clinical practice can advanced gastric cancer patients be effectively treated. At the same time,pay attention to the individual characteristics of patients,rational drug use,formulate a comprehensive treatment plan,and improve the treatment effect.

[1]
中华医学会肿瘤学分会,中华医学会杂志社. 中华医学会胃癌临床诊疗指南(2021版)[J]. 中华医学杂志2022102(16):1169-1189.
[2]
董志毅. 腔腹镜下胃癌根治术在早期胃癌患者中的治疗效果分析[J/CD]. 中华普外科手术学杂志(电子版)201812(04):312-314.
[3]
唐磊. 国际抗癌联盟及美国癌症联合会胃癌TNM分期系统(第8版)影像相关更新解读[J].中华放射学杂志201751(08):636-637.
[4]
陈俊良,王风华. 2021版CSC0胃癌诊疗指南转移性胃癌更新解读[J]. 中国肿瘤临床202249(07):325-330.
[5]
王冰. 新辅助化疗联合腹腔镜辅助胃癌根治术治疗进展期胃癌的效果[J]. 临床医学202242(01):20-23.
[6]
蔡慧,聂明明. RESOLVE研究对我国胃癌新辅助化疗的临床意义及展望[J]. 中国临床医学202229(01):1-6.
[7]
程波,刘巧珍,曹清. 细胞分裂周期因子25-A与胃癌化疗药物奥沙利铂联合5-氟尿嘧啶耐药的相关性研究[J]. 当代医学202228(13):84-86.
[8]
Cunningham DAllum WHStenning SP,et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer[J]. N Engl J Med2006355(1):11-20.
[9]
韦静涛,季鑫,季加孚. 不断提高中国胃癌外科手术治疗规范化[J/CD]. 中华普外科手术学杂志(电子版)202216(03):237-241.
[10]
Capovilla GFroiio CLang H,et al. [Complete response after neoadjuvant therapy for gastric cancer:implications for surgery][J]. Chirurg202293(2):138-143.
[11]
高毓,夏楠,周福祥. PRODIGY:多西他赛、奥沙利铂+S-1新辅助化疗联合手术及S-1辅助化疗对比手术及S-1辅助化疗治疗可切除局晚期胃癌的Ⅲ期研究[J]. 中华医学杂志2022102(12):857.
[12]
李宁,金晶. 放疗在局部进展期胃癌术前治疗中的应用价值存在局限和不足[J]. 中华胃肠外科杂志201821(10):1127-1128.
[13]
冯玲玲,张玉晶,张黎,等. 胃癌术前放化疗正常组织放射损伤的剂量效应分析[J]. 中华放射肿瘤学杂志201827(03):271-276.
[14]
吴楠,刘义冰. 晚期胃癌姑息治疗的研究进展[J]. 广东医学201637(03):465-467.
[15]
Zhang ZXGu XZYin WB,et al. Randomized clinical trial on the combination of preoperative irradiation and surgery in the treatment of adenocarcinoma of gastric cardia(AGC)--report on 370 patients[J]. Int J Radiat Oncol Biol Phys199842(5):929-934.
[16]
Van Hagen PHulshof MCvan Lanschot JJ,et al. Preoperative chemoradiotherapy for esophageal or junctional cancer[J]. N Engl J Med2012366(22):2074-2084.
[17]
Wu QLi GXu F. Resected gastric cancer with D2 dissection:advances in adjuvant chemoradiotherapy and radiotherapy techniques[J]. Expert Rev Anticancer Ther201515(6):703-713.
[18]
梁晓坤. 锥束CT智能精准引导放射治疗关键问题研究[D]. 北京:中国科学院大学,2021:1-113.
[19]
李宁,金晶. 放疗在局部进展期胃癌术前治疗中的应用价值存在局限和不足[J]. 中华胃肠外科杂志201821(10):1127-1128.
[20]
Zhang NFei QGu J,et al. Progress of preoperative and postoperative radiotherapy in gastric cancer[J]. World J Surg Oncol201816(1):187.
[21]
Cosma LSSchlosser STews HC,et al. Hereditary Diffuse Gastric Cancer:Molecular Genetics[J]. Int J Mol Sci202223(14):7821.
[22]
王璇. 晚期胃癌分子靶向治疗研究进展[J]. 菏泽医学专科学校学报202234(02):65-68.
[23]
杜彩妨,李慧. 晚期胃癌中少见靶点的特征与治疗进展[J]. 临床肿瘤学杂志202126(06):569-574.
[24]
张雅迪,张正,邵佳康,等. 人表皮生长因子受体2阳性乳腺癌的免疫治疗进展[J]. 中华微生物学和免疫学杂志202242(08):642-646.
[25]
程万里,刘鑫,任文俊,等. MicroRNA在肺腺癌表皮生长因子受体—酪氨酸激酶抑制剂耐药中的作用及其机制研究进展[J]. 山东医药202262(15):94-98.
[26]
张姣莉,李国庆. EGRF、CIP2A及c-Myc在胃癌细胞增殖中相互作用的关系[J]. 现代医药卫生201733(03):393-395.
[27]
Han YNChoi YJRhie SJ. Tolerability on Serious Adverse Events of First-Line Bevacizumab and Cetuximab for RAS Wild-Type Metastatic Colorectal Cancer:A Systematic Review and Meta-Analysis[J]. Healthcare(Basel)202210(2):217.
[28]
杨雪,何滔,时丽芳,等. CXCL14和EGFR在胃癌组织中的表达及其临床意义[J]. 中国肿瘤临床201643(19):860-864.
[29]
Mao CLSeow KMChen KH. The Utilization of Bevacizumab in Patients with Advanced Ovarian Cancer:A Systematic Review of the Mechanisms and Effects[J]. Int J Mol Sci202223(13):6911.
[30]
钱越,刘佳,李智,等. 索拉非尼联合二甲双胍对胃癌HGC-27细胞增殖的协同抑制作用[J]. 锦州医科大学学报202041(04):42-47.
[31]
Sun WPowell MO’Dwyer PJ,et al. Phase Ⅱ study of sorafenib in combination with docetaxel and cisplatin in the treatment of metastatic or advanced gastric and gastroesophageal junction adenocarcinoma:ECOG 5203[J]. J Clin Oncol201028(18):2947-2951.
[32]
吴清双,陈中杭,孙全春,等. 吡啶-吡唑酮衍生物的合成、晶体结构及抗肿瘤活性研究[J]. 分子科学学报201834(04):283-290.
[33]
韩艳珍,薛建鹏,胡加亮,等. 基质金属蛋白酶抑制剂类抗肿瘤药物临床研究进展[J]. 药学进展201842(02):129-137.
[34]
覃丽粒,马小波,赵天业,等. MMP-9和TIMP-1表达在胃癌根治术后患者预后评估中的作用[J]. 吉林大学学报(医学版)202248(01):163-171.
[35]
Schmidt DEbrahimabadi SGomes KRS,et al. Engineering CAR-NK cells:how to tune innate killer cells for cancer immunotherapy[J]. Immunother Adv20222(1):ltac003.
[36]
Moore EKStrazza MMor A. Combination Approaches to Target PD-1 Signaling in Cancer[J]. Front Immunol202213:927265.
[37]
成志勇,张丽军,付建珠,等. PD-1/PD-L1及Treg细胞在JAK2V617F阳性骨髓增殖性肿瘤中的表达及意义[J]. 中山大学学报(医学科学版)201940(01):98-103.
[38]
Liu ZYu XXu L,et al. Current insight into the regulation of PD-L1 in cancer[J]. Exp Hematol Oncol202211(1):44.
[39]
Aghamajidi AMaleki Vareki S. The Effect of the Gut Microbiota on Systemic and Anti-Tumor Immunity and Response to Systemic Therapy against Cancer[J]. Cancers(Basel)202214(15):3563.
[40]
Reck MRodríguez-Abreu DRobinson AG,et al. Pembrolizumab versus chemotherapy for PD-L1-positive non-small-cell lung cancer[J]. N Engl J Med2016375(19):1823-1833.
[41]
Kang YKBoku NSatoh T,et al. Nivolumab in patients with advanced gastric or gastro-oesophageal junction cancer refractory to,or intolerant of,at least two previous chemotherapy regimens(ONO-4538-12,ATTRACTION-2):a randomised,doubleblind,placebo-controlled,phase 3 trial[J]. Lancet2017390(10111):2461-2471.
[42]
Fuchs CSDoi TJang RW,et al. Safety and efficacy of Pembrolizumab Monotherapy in patients with previously treated advanced gastric and Gastroesophageal junction cancer:phase 2 clinical KEYNOTE-059 trial[J]. JAMA Oncol20184(5):e180013.
[43]
许斌,谌亮,宋启斌,查莉. 树突状细胞在肿瘤免疫和免疫治疗中的研究进展[J]. 现代肿瘤医学202129(14):2543-2547.
[44]
Kanazawa MYoshihara KAbe H,et al. Case report on intra-tumor injection therapy of dendritic cells in advanced gastric cancer[J]. Gan To Kagaku Ryoho200431(11):1773-1776.
[1] 安杰, 牛云峰, 刘伟. LINC00520 通过miR-519b-3p/HIF1A 轴促进胃癌的侵袭转移[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 430-436.
[2] 李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.
[3] 陈方鹏, 杨大伟, 金从稳. 腹腔镜近端胃癌切除术联合改良食管胃吻合术重建His角对术后反流性食管炎的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 15-18.
[4] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[5] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[6] 刘世君, 马杰, 师鲁静. 胃癌完整系膜切除术+标准D2根治术治疗进展期胃癌的近中期随访研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 27-30.
[7] 任佳, 马胜辉, 王馨, 石秀霞, 蔡淑云. 腹腔镜全胃切除、间置空肠代胃术的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 31-34.
[8] 王露, 周丽君. 全腹腔镜下远端胃大部切除不同吻合方式对胃癌患者胃功能恢复、并发症发生率的影响[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 92-95.
[9] 陈浩, 王萌. 胃印戒细胞癌的临床病理特征及治疗选择的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 108-111.
[10] 贺斌, 马晋峰. 胃癌脾门淋巴结转移危险因素[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 694-699.
[11] 梁孟杰, 朱欢欢, 王行舟, 江航, 艾世超, 孙锋, 宋鹏, 王萌, 刘颂, 夏雪峰, 杜峻峰, 傅双, 陆晓峰, 沈晓菲, 管文贤. 联合免疫治疗的胃癌转化治疗患者预后及术后并发症分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 619-623.
[12] 刘海旺, 施海, 尚利峰. 不同吻合器在腹腔镜远端胃癌根治术Roux-en-Y式吻合中的应用对比[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 643-646.
[13] 许杰, 李亚俊, 冯义文. SOX新辅助化疗后腹腔镜胃癌D2根治术与常规根治术治疗进展期胃癌的近期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 647-650.
[14] 陈伟杰, 何小东. 胆囊癌免疫靶向治疗进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 763-768.
[15] 张立俊, 孙存杰, 胡春峰, 孟冲, 张辉. MSCT、DCE-MRI 评估术前胃癌TNM 分期的准确性研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 519-523.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?