胃癌的治疗方法 胃癌的治疗方法
Alicia Gingrich1, Nicholas Manguso2, Randall Zuckerman2
1Division of Surgery, Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX 77025, USA.
胃癌腹膜转移 (GCPM) 患者需要针对向治疗进行瘤检测. 一些患者可能是新辅助或腹腔内治疗后手术的候选人.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 胃癌腹膜转移 (GCPM) 是第四阶段的疾病,需要先进的治疗策略.
- 系统治疗是管理GCPM的基石.
- 瘤标志物对于指导晚期胃癌治疗决策至关重要.
研究的目的:
- 概述了胃癌腹膜转移的患者目前的管理方法.
- 突出分子分析对个性化治疗的重要性.
- 为了确定手术干预的潜在候选人.
主要方法:
- 对GCPM的当前治疗指南和临床证据的审查.
- 强调分子测试,包括HER2,PD-L1和微卫星不稳定性 (MSI).
- 讨论新辅助疗法,腹腔内疗法和手术标准.
主要成果:
- 建议GCPM患者进行HER2,PD-L1和MSI的瘤检测,以确定他们是否有资格接受向治疗.
- 在新辅助疗法后的稳定疾病可能允许在同步GCPM中考虑手术.
- 腹腔内治疗可以导致积极细胞学的转化或低体积腹腔内疾病的解决 (腹腔内癌指数 [PCI] < 7),使患者成为胃切除术的候选人.
结论:
- 包含分子分析的个性化治疗策略对于GCPM至关重要.
- 多学科的方法对于选择可能从手术中受益的患者至关重要.
- 腹膜内治疗为有限的腹膜疾病的选择患者提供了潜在的细胞削减手术途径.
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