胃癌与腹腔转移的多模式管理中的当前挑战和未来方向
Andrea Cossu1, Francesco Puccetti1,2, Riccardo Rosati1,2
1Department of Gastrointestinal Surgery, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Cancers
|January 10, 2026
概括
准确的分期对于腹腔转移的胃癌至关重要. 新的局部区域疗法显示出希望,但个性化治疗需要预测生物标志物来更好地选择患者.
科学领域:
- 胃肠道学和瘤学
- 手术瘤学手术瘤学
- 翻译研究是翻译研究.
背景情况:
- 腹膜转移显著恶化胃癌的结果,尽管系统治疗的进步.
- 腹区具有独特的生物和药理动力学挑战,限制了全身治疗的有效性.
- 精确的分期,从腹腔镜开始,对于指导治疗决策至关重要.
研究的目的:
- 审查当前的胃癌与腹膜转移的管理格局.
- 突出系统疗法的局限性和地方区域方法的潜力.
- 强调需要预测生物标志物来个性化多式联络治疗策略.
主要方法:
- 审查最近的随机研究 (例如,ESTOK01,PERISCOPE II) 和正在进行的试验 (例如,PREVENT,GASTRICHIP).
- 讨论局部治疗方法,包括带有高热性腹腔内化学疗法 (CRS-HIPEC),加压性腹腔内气溶化学疗法 (PIPAC) 和常温性腹腔内化学疗法 (NIPS) 的细胞还原性手术.
- 分析整合全身和腹腔内治疗的挑战.
主要成果:
- 像CRS-HIPEC,PIPAC和NIPS这样的地方区域方法在精选的胃癌患者中显示出令人鼓舞的结果.
- 最近的试验强调了患者选择,技术标准化和最佳治疗顺序的重要性.
- 目前的全身疗法在腹区内影响有限.
结论:
- 腹腔转移的胃癌的有效管理需要采用综合系统和局部区域战略的多模式方法.
- 没有经过验证的预测生物标志物阻碍了个性化治疗选择和临床进展.
- 未来的进步取决于确定强大的生物预测因子,以指导合理的患者选择和开发个性化疗法.
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