摘要
Prognosis of locally advanced gastric cancer remains poor, and several multimodality strategies involving surgery, chemotherapy, and radiation have been tested in clinical trials. Phase Ⅲ trial testing the benefit of postoperative adjuvant chemotherapy over treatment with surgery alone have revealed little impact on survival, with the exception of some small trials in Western nations. A large trial from the United States exploring postoperative chemoradiation was the first major success in this category. Results from Japanese trials suggest that moderate chemotherapy with oral fluoropyrimidines may be effective against less-advanced （T2-stage） cancer, although another confirmative trial is needed to prove this point. Investigators have recently turned to neoadjuvant chemotherapy, and some promising results have been reported from phase Ⅱ trials using active drug combinations. In 2005, a large phase Ⅲ trial testing preand postoperative chemotherapy has proven its survival benefit for resectable gastric cancer. Since the rate of pathologic complete response is considered to affect treatment results of this strategy, neoadjuvant chemoradiation that further increases the incidence of pathologic complete response could be a breakthrough, and phase Ⅲ studies testing this strategy may be warranted in the near future.
局部地先进的胃的癌症的预后仍然保持差，并且几多，包含外科，化疗，和放射的形式策略在临床的试用被测试了。独自与外科在治疗上测试手术后的辅助化疗的利益的阶段 III 试用几乎没在幸存上揭示很少影响，与在西方的国家的一些小试用的例外。从探索手术后的 chemoradiation 的美国的大试用是在这个范畴的第一主要成功。从日本试用的结果建议有口头的 fluoropyrimidines 的中等化疗可能对更少进展(T2 阶段) 是有效的癌症，尽管另一确定的试用被需要证明这，指。调查者最近转到 neoadjuvant 化疗，并且一些有希望的结果从阶段 II trials using 被报导了活跃的药联合。在 2005，测试在前和手术后的化疗的大阶段 III 试用为将切除证明了它的幸存利益有能力的胃的癌症。因为病理学的完全的反应的率被认为影响这策略的治疗结果，进一步增加病理学的完全的反应的发生的 neoadjuvant chemoradiation 能是突破，并且分阶段执行测试这策略的 III 研究在不久的将来可以被保证。
