不可切除胃癌“转化治疗”的临床进展

Conversion therapy for unresectable gastric cancer

不可切除胃癌是指初次确诊时病期较晚、难以根治性切除的病例,其总体预后不佳,目前的国际胃癌指南推荐以姑息化疗为其主要治疗方式.近年来有许多临床研究发现,通过给予合理的化疗、放疗、靶向、介入、腹腔热灌注治疗等综合治疗,结合多学科团队(multidisciplinary team,MDT)评价,许多不可切除胃癌病例能够"转化"为可根治性切除的病例,从而显著延长患者生存时间并提高其生活质量.本文就不可切除胃癌的治疗现状与进展、"转化治疗"的应用策略以及病例选择等做了全面的综述.

Unresectable gastric cancer cases are often diagnosed at a far advanced stage, which are hard to resect radically and suffer a poor prognosis. Therefore, palliative chemotherapy is recommended as the main treatment by the current clinical guidelines for gastric cancer. Fortunately, in clinical studies revealed recent years some that after treatment with chemotherapy, radiotherapy, targeted therapy, interventional therapy, hyperthermic intraperitoneal chemotherapy （HIPEC） and so on, and multidisciplinary assessment, many unresectable gastric cancer cases could be converted into resectable cases, which consequently prolongs their survival time and improves their quality of life significantly. In the present review, we summarize the status and progress of treatment for unresectable gastric cancer, as well as the strategy and case selection for conversion therapy.