Gastric cancer is one of the most common malignant tumors,for patients with advanced gastric cancer,the traditional treatment is mainly chemotherapy or combined targeted therapy;however,these have not achieved ideal e...Gastric cancer is one of the most common malignant tumors,for patients with advanced gastric cancer,the traditional treatment is mainly chemotherapy or combined targeted therapy;however,these have not achieved ideal efficacy.However,with the continuous deepening of research on molecular targeted drugs and immunosuppressants,the treatment of advanced gastric cancer patients has made new progress,and some new technologies have also been continuously emerged and applied,which brings hope for the treatment of advanced gastric cancer.Recently,several multicenter randomized controlled phase III studies on immunotherapy for advanced gastric cancer yielded encouraging results,demonstrating its superior efficacy in the treatment of advanced gastric cancer.However,prospective data to support the acceptance of surgery and the R0 removal rate following conversion therapy with immune checkpoint inhibitors are lacking.In this study,a 58-year-old woman with advanced gastric cancer and positive PD-L1 expression,negative HER-2 expression,and microsatellite stable status received immunochemotherapy combined with traditional Chinese medicine to achieve R0 resection and satisfactory efficacy.展开更多
The 2023 update of the Chinese Society of Clinical Oncology(CSCO)Clini-cal Guidelines for Gastric Cancer focuses on standardizing cancer diagnosis and treatment in China,reflecting the latest advancements in evidence-...The 2023 update of the Chinese Society of Clinical Oncology(CSCO)Clini-cal Guidelines for Gastric Cancer focuses on standardizing cancer diagnosis and treatment in China,reflecting the latest advancements in evidence-based medicine,healthcare resource availability,and precision medicine.These updates address the differences in epidemiological characteristics,clinicopatho-logical features,tumor biology,treatment patterns,and drug selections between Eastern and Western gastric cancer patients.Key revisions include a structured template for imaging diagnosis reports,updated standards for molecular marker testing in pathological diagnosis,and an elevated recommendation for neoadju-vant chemotherapy in stage III gastric cancer.For advanced metastatic gastric cancer,the guidelines introduce new recommendations for immunotherapy,anti-angiogenic therapy and targeted drugs,along with updated management strategies for human epidermal growth factor receptor 2(HER2)-positive and deficient DNA mismatch repair(dMMR)/microsatellite instability-high(MSI-H)patients.Additionally,the guidelines offer detailed screening recommendations for hereditary gastric cancer and an appendix listing drug treatment regimens for various stages of gastric cancer.The 2023 CSCO Clinical Guidelines for Gastric Cancer updates are based on both Chinese and international clinical research and expert consensus to enhance their applicability and relevance in clinical practice,particularly in the heterogeneous healthcare landscape of China,while maintaining a commitment to scientific rigor,impartiality,and timely revisions.展开更多
There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and ...There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and Western countries.The Chinese Society of Clinical Oncology(CSCO)has organized a panel of senior experts specializing in all sub-specialties of gastric cancer to compile a clinical guideline for the diagnosis and treatment of gastric cancer since 2016 and renews it annually.Taking into account regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted expert consensus judgment on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes in China.The 2021 CSCO Clinical Practice Guidelines for Gastric Cancer covers the diagnosis,treatment,follow-up,and screening of gastric cancer.Based on the 2020 version of the CSCO Chinese Gastric Cancer guidelines,this updated guideline integrates the results ofmajor clinical studies from China and overseas for the past year,focused on the inclusion of research data from the Chinese population for more personalized and clinically relevant recommendations.For the comprehensive treatment of non-metastatic gastric cancer,attentions were paid to neoadjuvant treatment.The value of perioperative chemotherapy is gradually becoming clearer and its recommendation level has been updated.For the comprehensive treatment of metastatic gastric cancer,recommendations for immunotherapy were included,and immune checkpoint inhibitors fromthird-line to the first-line of treatment for different patient groups with detailed notes are provided.展开更多
China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and ...China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selection between gastric cancer patients from the Eastern and Western countries.Non-Chinese guidelines cannot specifically reflect the diagnosis and treatment characteristics for the Chinese gastric cancer patients.The Chinese Society of Clinical Oncology(CSCO)arranged for a panel of senior experts specializing in all sub-specialties of gastric cancer to compile,discuss,and revise the guidelines on the diagnosis and treatment of gastric cancer based on the findings of evidence-based medicine in China and abroad.By referring to the opinions of industry experts,taking into account of regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted experts’consensus judgement on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes.This guideline uses tables and is complemented by explanatory and descriptive notes covering the diagnosis,comprehensive treatment,and follow-up visits for gastric cancer.展开更多
Objective:To observe the efficacy of Chinese medicine comprehensive therapeutic project in treating the middle/late stage primary hepatic carcinoma(PHC).Methods:With prospective randomized controlled design, 97 pa...Objective:To observe the efficacy of Chinese medicine comprehensive therapeutic project in treating the middle/late stage primary hepatic carcinoma(PHC).Methods:With prospective randomized controlled design, 97 patients with PHC were assigned to the test group(49 cases) treated with Chinese medicine comprehensive therapy using Oleum fructus bruceas intervention combining oral intake of Ganji Decoction(肝积方) and external application of Ailitong(癌理通),and the control group(48 cases) treated with chemotherapeutic agents combining iodized oil chemo-embolization and analgesics.The immediate and long-term efficacy,adverse reaction,pain-relieving initial time(PRIT) and pain-relieving sustained time(PRST) of the treatment,as well as the change in patients' quality of life(QOL) were observed.Results:The difference between the two groups in illness control rate was statistically insignificant(P〉0.05),but the adverse reaction occurence rate in the test group was lesser than that in the control group(P〈0.05).PRIT was insignificantly different in the two groups(P〉0.05),but the PRST was significantly superior in the test group than that in the control group(10.37±2.18 h vs 7.78±1.95 h,P〈0.01).After treatment,the increased Karnofsky scores in the test group indicated that the patients' somatic activity,symptoms and QOL were improved significantly,which were significantly superior to those in the control group(P〈0.05).The survival rate in the two groups was similar at the 3rd month after treatment,but the test group did show superiority in terms of half- and 1-year survival rate(65.9%vs 42.5%and 38.6%vs 18.1%,respectively,P〈0.05).The median survival time in the test group was 8.9 months and that in the control group was 5.3 months.Conclusion:Chinese medicine comprehensive therapy is an effective treatment for the middle/late stage patients of PHC,and it could extend the PRST,improve the patients' QOL and long-term survival with less adverse reaction.展开更多
胃癌前病变(precancerous lesions of gastric cancer,PLGC)是胃癌发展的关键阶段,尽早诊断、及时干预PLGC是预防胃癌发生的重点,如何减缓或逆转PLGC,降低人群中胃癌的发病率、病死率是现阶段消化领域研究的热点问题。当前西医主要采用...胃癌前病变(precancerous lesions of gastric cancer,PLGC)是胃癌发展的关键阶段,尽早诊断、及时干预PLGC是预防胃癌发生的重点,如何减缓或逆转PLGC,降低人群中胃癌的发病率、病死率是现阶段消化领域研究的热点问题。当前西医主要采用抑酸、抗幽门螺杆菌(Helicobacter Pylori,HP)感染、内镜下治疗、定期随访等措施来治疗PLGC,但主要是针对病因及症状的治疗,对PLGC的逆转多无确切疗效。许多研究证实中医药治疗PLGC具有独特优势,辨证论治与辨病论治相结合,联合胃镜、组织病理学、血清学、基因组学表现精准靶向治疗PLGC,不仅能有效改善患者临床症状,且能不同程度逆转PLGC,减缓疾病进程,但具体机制尚未完全明确。该文就中医药精准靶向治疗PLGC及其相关信号通路进行概述,以期为中医药治疗该病提供理论基础及机制研究。展开更多
文摘Gastric cancer is one of the most common malignant tumors,for patients with advanced gastric cancer,the traditional treatment is mainly chemotherapy or combined targeted therapy;however,these have not achieved ideal efficacy.However,with the continuous deepening of research on molecular targeted drugs and immunosuppressants,the treatment of advanced gastric cancer patients has made new progress,and some new technologies have also been continuously emerged and applied,which brings hope for the treatment of advanced gastric cancer.Recently,several multicenter randomized controlled phase III studies on immunotherapy for advanced gastric cancer yielded encouraging results,demonstrating its superior efficacy in the treatment of advanced gastric cancer.However,prospective data to support the acceptance of surgery and the R0 removal rate following conversion therapy with immune checkpoint inhibitors are lacking.In this study,a 58-year-old woman with advanced gastric cancer and positive PD-L1 expression,negative HER-2 expression,and microsatellite stable status received immunochemotherapy combined with traditional Chinese medicine to achieve R0 resection and satisfactory efficacy.
文摘The 2023 update of the Chinese Society of Clinical Oncology(CSCO)Clini-cal Guidelines for Gastric Cancer focuses on standardizing cancer diagnosis and treatment in China,reflecting the latest advancements in evidence-based medicine,healthcare resource availability,and precision medicine.These updates address the differences in epidemiological characteristics,clinicopatho-logical features,tumor biology,treatment patterns,and drug selections between Eastern and Western gastric cancer patients.Key revisions include a structured template for imaging diagnosis reports,updated standards for molecular marker testing in pathological diagnosis,and an elevated recommendation for neoadju-vant chemotherapy in stage III gastric cancer.For advanced metastatic gastric cancer,the guidelines introduce new recommendations for immunotherapy,anti-angiogenic therapy and targeted drugs,along with updated management strategies for human epidermal growth factor receptor 2(HER2)-positive and deficient DNA mismatch repair(dMMR)/microsatellite instability-high(MSI-H)patients.Additionally,the guidelines offer detailed screening recommendations for hereditary gastric cancer and an appendix listing drug treatment regimens for various stages of gastric cancer.The 2023 CSCO Clinical Guidelines for Gastric Cancer updates are based on both Chinese and international clinical research and expert consensus to enhance their applicability and relevance in clinical practice,particularly in the heterogeneous healthcare landscape of China,while maintaining a commitment to scientific rigor,impartiality,and timely revisions.
文摘There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and Western countries.The Chinese Society of Clinical Oncology(CSCO)has organized a panel of senior experts specializing in all sub-specialties of gastric cancer to compile a clinical guideline for the diagnosis and treatment of gastric cancer since 2016 and renews it annually.Taking into account regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted expert consensus judgment on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes in China.The 2021 CSCO Clinical Practice Guidelines for Gastric Cancer covers the diagnosis,treatment,follow-up,and screening of gastric cancer.Based on the 2020 version of the CSCO Chinese Gastric Cancer guidelines,this updated guideline integrates the results ofmajor clinical studies from China and overseas for the past year,focused on the inclusion of research data from the Chinese population for more personalized and clinically relevant recommendations.For the comprehensive treatment of non-metastatic gastric cancer,attentions were paid to neoadjuvant treatment.The value of perioperative chemotherapy is gradually becoming clearer and its recommendation level has been updated.For the comprehensive treatment of metastatic gastric cancer,recommendations for immunotherapy were included,and immune checkpoint inhibitors fromthird-line to the first-line of treatment for different patient groups with detailed notes are provided.
文摘China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selection between gastric cancer patients from the Eastern and Western countries.Non-Chinese guidelines cannot specifically reflect the diagnosis and treatment characteristics for the Chinese gastric cancer patients.The Chinese Society of Clinical Oncology(CSCO)arranged for a panel of senior experts specializing in all sub-specialties of gastric cancer to compile,discuss,and revise the guidelines on the diagnosis and treatment of gastric cancer based on the findings of evidence-based medicine in China and abroad.By referring to the opinions of industry experts,taking into account of regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted experts’consensus judgement on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes.This guideline uses tables and is complemented by explanatory and descriptive notes covering the diagnosis,comprehensive treatment,and follow-up visits for gastric cancer.
基金Supported by Guangdong Administration of Sciences and Technology(No.2005B36001012)
文摘Objective:To observe the efficacy of Chinese medicine comprehensive therapeutic project in treating the middle/late stage primary hepatic carcinoma(PHC).Methods:With prospective randomized controlled design, 97 patients with PHC were assigned to the test group(49 cases) treated with Chinese medicine comprehensive therapy using Oleum fructus bruceas intervention combining oral intake of Ganji Decoction(肝积方) and external application of Ailitong(癌理通),and the control group(48 cases) treated with chemotherapeutic agents combining iodized oil chemo-embolization and analgesics.The immediate and long-term efficacy,adverse reaction,pain-relieving initial time(PRIT) and pain-relieving sustained time(PRST) of the treatment,as well as the change in patients' quality of life(QOL) were observed.Results:The difference between the two groups in illness control rate was statistically insignificant(P〉0.05),but the adverse reaction occurence rate in the test group was lesser than that in the control group(P〈0.05).PRIT was insignificantly different in the two groups(P〉0.05),but the PRST was significantly superior in the test group than that in the control group(10.37±2.18 h vs 7.78±1.95 h,P〈0.01).After treatment,the increased Karnofsky scores in the test group indicated that the patients' somatic activity,symptoms and QOL were improved significantly,which were significantly superior to those in the control group(P〈0.05).The survival rate in the two groups was similar at the 3rd month after treatment,but the test group did show superiority in terms of half- and 1-year survival rate(65.9%vs 42.5%and 38.6%vs 18.1%,respectively,P〈0.05).The median survival time in the test group was 8.9 months and that in the control group was 5.3 months.Conclusion:Chinese medicine comprehensive therapy is an effective treatment for the middle/late stage patients of PHC,and it could extend the PRST,improve the patients' QOL and long-term survival with less adverse reaction.