中国实用外科杂志

中国实用外科杂志

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晚期胃癌综合治疗理念更新

彭    智，沈    琳   

  1. 北京大学肿瘤医院暨北京市肿瘤防治研究所消化肿瘤内科 恶性肿瘤发病机制及转化研究教育部重点实验室，北京 100142
  • 出版日期:2017-10-01 发布日期:2017-10-11

  • Online:2017-10-01 Published:2017-10-11

摘要：

随着对胃癌分子生物学和临床特征的深入认识以及药物疗效的不断提升，晚期胃癌的治疗理念也在逐渐变化。在循证医学证据的基础上深入了解晚期胃癌病人个体差异，贯穿全程多学科综合治疗理念，才能实现个体化精准诊治。晚期胃癌应采用以化疗为主的综合治疗，随着新药物出现，部分生物学行为良好的晚期胃癌病人也可能通过转化治疗获得手术切除达到治愈或延长生存的目的。此外，姑息治疗、人文关怀也是综合治疗的重要内容。须明确治疗目标，在治疗过程中动态评估，尽量延长病人生存，提高生活质量。

关键词: 晚期胃癌, 多学科综合治疗, 转化治疗, 手术治疗

Abstract:

Update and progress of comprehensive treatment for advanced gastric cancer        PENG Zhi，SHEN Lin. Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute；Key Laboratory of Carcinogenesis and Translational Research（Ministry of Education），Beijing 100142，China
Corresponding author: SHEN Lin，E-mail：linshenpku@163.com
Abstract    With the comprehensive understanding of molecular biology and clinical characteristics of gastric cancer as well as the continuous improvement of effective drugs, the concept for advanced gastric cancer therapy is gradually changing. According to evidence-based medicine, it is necessary to understand individual differences of advanced gastric cancer further, and to carry out multidisciplinary treatment concept to achieve personalized therapy. Advanced gastric cancer needs chemotherapy-based comprehensive treatment. With the improvement of patients’ biological behavior by new effective drugs, some advanced gastric cancer may receive surgical resection for cure or longer survival through transformation and multidisciplinary therapy. Palliative and humanistic care is also important for advanced gastric cancer treatment. It is necessary to define the goal, evaluate the procedure dynamically, prolong the survival，and improve the quality of life.

Key words: advanced gastric cancer, multi-disciplinary therapy, conversion therapy, surgical treatment