中国癌症杂志 ›› 2022, Vol. 32 ›› Issue (7): 581-587.doi: 10.19401/j.cnki.1007-3639.2022.07.001
收稿日期:
2022-06-02
出版日期:
2022-07-30
发布日期:
2022-08-09
通信作者:
陈佳艺
E-mail:caigangcg@163.com;chenjiayi0188@aliyun.com
作者简介:
蔡钢(ORCID: 0000-0001-8071-4422),博士,副主任医师,E-mail: caigangcg@163.com。
CAI Gang()(
), WANG Shubei, CHEN Jiayi(
)(
)
Received:
2022-06-02
Published:
2022-07-30
Online:
2022-08-09
Contact:
CHEN Jiayi
E-mail:caigangcg@163.com;chenjiayi0188@aliyun.com
文章分享
摘要:
胃癌是常见的消化道恶性肿瘤之一。放疗是胃癌综合治疗的重要手段之一。近年来,包括放疗在内的局部进展期胃癌的围手术期治疗的探索不断取得突破,这些疗法对胃癌患者生存的积极影响也越来越明显。近年来在胃癌的新辅助放疗、辅助放疗、进展期肿瘤放疗及免疫联合放疗领域均有新的研究成果。本文深入分析国内外的相关研究进展,系统阐述放疗在胃癌治疗中的应用现状与进展。
中图分类号:
蔡钢, 王舒蓓, 陈佳艺. 放射治疗在胃癌全程管理中的现状与挑战[J]. 中国癌症杂志, 2022, 32(7): 581-587.
CAI Gang, WANG Shubei, CHEN Jiayi. The current data and challenge of radiotherapy in the case management of gastric cancer[J]. China Oncology, 2022, 32(7): 581-587.
表1
局部进展期胃癌新辅助放化疗相关研究"
Study | Publication year | Country/region | Study design | Tumor site | Group | R0 resection rate | pCR rate | OS |
---|---|---|---|---|---|---|---|---|
CROSS[ | 2012 | Netherlands | Phase Ⅲ randomized control | Esophagus/esophagogastric junction | Surgery (n=188); Carboplatin+taxol+radiotherapy+surgery (n=178) | 69%; 92% | -; 29% | 24.0 months (median OS); 49.4 months (median OS) |
POET[ | 2009 | Germany | Phase Ⅲ randomized control | Esophagus/gastric cardia | Cisplatin+FU/LV (n=59); Cisplatin+FU/LV+radiotherapy (concurrent chemotherapy: cisplatin+etoposide) (n=60) | 70%; 72% | 2%; 16% | 24.4% (5-year OS rate); 39.5% (5-year OS rate) |
NEO-AEGIS | 2021 (preliminary result) | International | Phase Ⅲ randomized control | Esophagus/esophagogastric junction | ECF/ECX/EOF/EOX, FLOT (n=184); Carboplatin+taxol+radiotherapy (n=178) | 82%; 95% | 5%; 16% | 56% (3-year OS rate); 57% (3-year OS rate) |
TOPGEAR[ | 2017 (midterm result) | Europe, Canada | Phase Ⅲ randomized control | Esophagogastric junction/gastric | ECF/ECX+surgery+ECF/ECX (n=60); ECF/ECX+radiotherapy+surgery+ECF/ECX (n=60) | |||
PREACT | Ongoing | China | Phase Ⅲ randomized control | Esophagogastric junction/gastric | SOX+chemoradiotherapy+SOX+surgery+SOX; SOX+surgery+SOX | |||
CRITICS Ⅱ | Ongoing | Netherlands | Phase Ⅲ randomized control | Gastric | DOC+surgery; DOC+chemoradiotherapy+surgery; Chemoradiotherapy+surgery | |||
ESOPEC | Ongoing | Germany | Phase Ⅲ randomized control | Gastric | FLOT+surgery+FOLT; Chemoradiotherapy+surgery | |||
5010 | Ongoing | China | Phase Ⅲ randomized control | Gastric | Radiotherapy+XELOX+surgery+XELOX; XELOX+surgery+XELOX |
表2
局部进展期胃癌辅助放化疗相关研究"
Study | Publication year | Country/region | Study design | Group | Surgical method | DFS | OS |
---|---|---|---|---|---|---|---|
INT-0116[ | 2012 | North America | Phase Ⅱ randomized control | Surgery (n=277); Surgery+radiotherapy+FU/LV (n=282) | D1 or D2 | 19 months (median DFS); 27 months (median DFS) | 27 months (median OS); 35 months (median OS) |
ARTIST[ | 2012 | Korea | Phase Ⅲ randomized control | Surgery+XP (n=228); Surgery+XP+radiotherapy (n=230) | D2 | 74.2% (3-year DFS rate); 78.2% (3-year DFS rate) | 73% (5-year OS rate); 75% (5-year OS rate) |
ARTIST Ⅱ[ | 2021 | Korea | Phase Ⅲ randomized control | Surgery+S-1 (n=182); Surgery+SOX (n=181); Surgery+SOX+radiotherapy (n=183) | D2 | 64.8% (3-year DFS rate); 74.3% (3-year DFS rate); 72.8% (3-year DFS rate) | |
CRITICS[ | 2018 | Netherlands | Phase Ⅲ randomized control | Chemotherapy+surgery+chemotherapy (n=393); Chemotherapy+surgery+chemoradiotherapy (n=395) | D1 or above | ITT: no difference; PP: 57.9% and 45.5% (5-year OS rate) |
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