局部进展期胃癌的新辅助治疗

Neoadjuvant treatment for locally advanced gastric cancer

胃癌位居中国恶性肿瘤发病率和死亡率第2位,严重危害国人的生命和健康;由于早期症状不典型、筛查体系不完善,中国约70%的胃癌患者确诊时已处于局部进展期。根治性手术是局部进展期胃癌最主要的治疗方式,但单纯手术治疗和传统的手术联合术后辅助治疗效果均不甚理想术前新辅助治疗具有降低肿瘤分期、减小肿瘤原发灶、消除肿瘤微转移、减少术中散播和术后复发、提高胃癌根治性切除率等优点。近年来,化疗、放射治疗、靶向治疗、免疫治疗在局部进展期胃癌术前新辅助治疗中的探索和应用不断取得进展。新辅助治疗已成为局部进展期胃癌重要的治疗模式。

Gastric cancer is the second most common and the second leading cause of cancer related mortality in China,which seriously endanger the lives and health of Chinese people.Due to the lack of typical symptoms and screening system of early gastric cancer,about 70%patients with gastric cancer are diagnosed as locally advanced disease in China.Radical resection is the main approach for loc ally advanced gastric cancer(LAGC),however,the clinical effect of gastrectomy alone or gastrectomy plus adjuvant treatment is limited.As a result,there has been increasing interest in the neoadjuvant treatment,which could potentially downstage tumor,eliminate tumor micrometastasis,reduce intraoperative dissemination and postoperative recurrence,thus improve the prognosis of patients with LAGC.The exploration and application of chemotherapy,radiotherapy,targeted therapy and immunotherapy of neoadjuvant treatment in LAGC have made continuous progress in recent years.To date,neoadjuvant therapy has been developed as a part of multimodality treatment for patients with LAGC.