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胃癌術后輔助治療方案Ⅲ

方案評價

續表

點評

XP方案聯合放療目前可用于胃癌D2術后患者的輔助治療,尤其是Ⅰb~Ⅳ(M0)期胃癌D2術后,淋巴結陽性比>25%及腸型胃癌患者中。該ARTIST研究(NCT00411229)是由韓國研究者發起的Ⅲ期隨機對照試驗,旨在比較Ⅰb~Ⅳ(M0)期胃癌D2術后輔助放化療(卡培他濱+順鉑+RT)的有效性和安全性,與單純輔助XP的患者相比,胃癌D2術后的同步放化療較單純化療不能改善DFS和OS,但是有淋巴結轉移(淋巴結清掃比率>25%)及腸型胃癌患者中有潛在獲益的可能。

(張 濤 于丹丹)

參考文獻

[1] YU JI,LIM DH,AHN YC,et al.Effects of adjuvant radiotherapy on completely resected gastric cancer:A radiation oncologist's view of the ARTIST randomized phaseⅢ trial.Radiotherapy and Oncology,2015,117:171-177.

[2] KIM Y,PARK SH,KIM K-M,et al.The influence of metastatic lymph node ratio on the treatment outcomes in the adjuvant chemoradiotherapy in stomach tumors(ARTIST)trial:A phaseⅢ trial.Journal of Gastric Cancer,2016,16:105-110.

[3] LEE J,LIM DH,KIM S,et al.Phase Ⅲ trial comparing capecitabine plus cisplatin versus capecitabine plus cisplatin with concurrent capecitabine radiotherapy in completely resected gastric cancer with D2 lymph node dissection:The ARTIST trial.J Clin Oncol,2012,30:268-273.

[4] PARK S,SOHN TS,LEE J,et al.Phase Ⅲ trial to compare adjuvant chemotherapy with capecitabine and cisplatin versus concurrent chemoradiotherapy in gastric cancer:final report of the adjuvant chemoradiotherapy in stomach tumors trial,including survival and subset analyses.J Clin Oncol,2015,33:3130-3136.

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