CAJ | 학술논문

胃癌在全球最常见恶性肿瘤中排名第四位,是恶性肿瘤第二大死因;其发现多在晚期,已经失去了根治性手术机会.晚期胃癌治疗手段主要包括姑息性手术治疗、放疗、化疗、生物免疫治疗、中医药治疗.姑息性手术治疗主要用于减轻患者肿瘤负荷,或减少并发症的发生;放疗在局部晚期胃癌的治疗中具有一定的效用.化疗在晚期胃癌治疗中可发挥主导作用,对有症状的患者有姑息性治疗效果.由FAX方案到ECF/DCF方案,再到REAL-2试验、ML17032、SPIRITS试验等几项里程碑式的随机性Ⅲ期临床研究结果的公布,关于晚期或转移性胃癌化疗的研究一直是关注的焦点,随着EOX、XP、S-1/CDDP、IF、FOLFOX、XELOX等化疗方案相继提出,晚期胃癌的临床疗效有了进一步提高,但目前尚未得到优势明显的标准治疗方案.胃癌的生物免疫治疗也逐渐成为研究热点,它是对手术和化、放疗的有益补充,但还不能作为主干性疗法.无论手术、放疗,或是化疗、生物免疫治疗,其在发挥疗效的同时,均具有明显的副作用.因此,采用中药内服外用、针灸推拿、心理干预等多种综合治疗手段,发挥中西医结合在缓解临床症状、对化、放疗减毒与增效、提高患者生存质量、预防肿瘤复发与转移、逆转肿瘤细胞多药耐药、治疗癌性腹水及癌性疼痛等方面的特色与优势,同样具有重要临床价值.
위암재전구최상견악성종류중배명제사위,시악성종류제이대사인;기발현다재만기,이경실거료근치성수술궤회.만기위암치료수단주요포괄고식성수술치료、방료、화료、생물면역치료、중의약치료.고식성수술치료주요용우감경환자종류부하,혹감소병발증적발생;방료재국부만기위암적치료중구유일정적효용.화료재만기위암치료중가발휘주도작용,대유증상적환자유고식성치료효과.유FAX방안도ECF/DCF방안,재도REAL-2시험、ML17032、SPIRITS시험등궤항리정비식적수궤성Ⅲ기림상연구결과적공포,관우만기혹전이성위암화료적연구일직시관주적초점,수착EOX、XP、S-1/CDDP、IF、FOLFOX、XELOX등화료방안상계제출,만기위암적림상료효유료진일보제고,단목전상미득도우세명현적표준치료방안.위암적생물면역치료야축점성위연구열점,타시대수술화화、방료적유익보충,단환불능작위주간성요법.무론수술、방료,혹시화료、생물면역치료,기재발휘료효적동시,균구유명현적부작용.인차,채용중약내복외용、침구추나、심리간예등다충종합치료수단,발휘중서의결합재완해림상증상、대화、방료감독여증효、제고환자생존질량、예방종류복발여전이、역전종류세포다약내약、치료암성복수급암성동통등방면적특색여우세,동양구유중요림상개치.
Gastric cancer is the fourth most common cancer and is the second leading cause of cancer death worldwide. Gastric cancer is usually in advanced stage at diagnosis, without opportunity for curative resection. Chemotherapy is the major treatment for advanced gastric cancer (AGC), and other treatments include palliative surgery, radiotherapy, chemotherapy, biologic and immunologic therapy as well as Chinese medicine. Palliative therapy is used to reduce tumor load or complication occurrence, while radiotherapy is effective for locoregionally advanced gastdc cancer. At present, chemotherapy plays a leading role in AGC treatment and has a palliative effect on symptomatic patients. For advanced or metastatic gastric cancer, chemotherapy has always been the focus of studies. Results of studies of FAX, ECF/DCF regimens and Phrase ill clinical trials of REAL-2, ML17032 and SPIRITS have been released. With the application of EOX, XP, S-1/CDDP, IF, FOLFOX and XELOX regimens, the outcomes of advanced gastdc cancer are improved. However, there is no standard regimen accepted as supedor over others. Biologic and immunologic therapy are beneficial supplements to surgery, chemotherapy and radiotherapy, but are not yet the mainstream. All of these treatments have obvious side effects. Other comprehensive methods are of equal importance, such as Chinese herbal medicine, acupuncture and moxibustion, and psychological intervention. Combined with western medicine, the above methods have certain merits in relieving clinical symptoms, reducing toxicity,increasing effectiveness, improving quality of life, preventing metastasis and recurrence, reversing multidrug resistance of tumor cells, and curing ascites and managing cancer pain.