从控制到转换:优化系统性治疗治疗的治疗意图转换手术在转移性胃癌
Hye Sook Han1, Sun Young Rha2,3,4
1Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
Journal of gastric cancer
|January 10, 2026
概括
转化疗法,使用先进的全身治疗,如向药物和免疫检查点抑制剂 (ICI),可以使最初无法切除的转移性胃癌可操作,改善生存结果.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 转化疗法旨在在最初无法切除的转移性癌症中进行治愈切除.
- 系统疗法 (向药物,ICI) 的进步使人们对转化疗法对转移性胃癌 (GC) 的兴趣重新获得活力.
研究的目的:
- 对转移性GC转化疗法的国际指导方针和专家共识进行审查.
- 强调系统治疗,生物标志物驱动的策略和手术时间的作用.
主要方法:
- 对关键的共识声明的审查 (Bertinoro,OMEC,KINGCA WEEK 2024). 这是一个很好的例子.
- 从细胞毒性,向性和免疫疗法时代的关键研究分析.
- 专注于治疗方案的选择,治疗持续时间,以及手术结果的预后因素.
主要成果:
- 转换手术不是标准的,但对于某些对全身治疗有重大反应的患者来说,可以考虑这样做.
- 转换疗法后的R0切除显示了24-36个月 (细胞毒性时代) 和>48个月 (ICI/向时代) 的中位数整体存活率.
- 最佳时间包括~6个月的手术前全身治疗,R0切除,以及长达1年的术后维持治疗.
结论:
- 转换手术是有效的全身治疗的延伸,而不是替代.
- 一种以生物学为导向的多学科方法,整合反应评估和预后因素,是潜在的转移性GC治愈管理的关键.
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