Current Status of Multimodal Therapy for A vanced Gastric Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HE Yunsheng , J IANG Huaiwu.

The S econd Department of General S urgery , The S econd A f f i l icated Hos pi tal of N orthern S ichuan Medical College,Mianyang 404 Hospital , Mianyang 621000 , China;

Corresponding author：

Keywords：

Advanced gast ric carcinoma, Multimodal therapy

Video：

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Objective 　To review the research advancement of multimodal therapy for advanced gast ric carcinoma. Methods 　The literatures on multimodal therapy for advanced gastric carcinoma in recent years were collected and reviewed. Results 　The multimodal therapy , such as preoperative chemotherapy , preoperative adjuvant chemoradiotherapy , preoperative interventional chemoradiotherapy for advanced gast ric carcinoma was effective because it could increase the rate of R0 resection for the patients with advanced gastric carcinoma. And it can decrease the mortality rate after operation , extend the overall survival time and improve patients’life quality. Conclusion 　Multimodal therapy is a promising method for the treatment of advanced gastric carcinoma and it should be further developed.

Citation： HE Yunsheng,J IANG Huaiwu.. Current Status of Multimodal Therapy for A vanced Gastric Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(1): 31-35. doi: Copy

1.	<>[1]Higuchi K,Phan A,Ajani JA.Gastric cancer:advances in adjuvant and adjunct therapy[J].Curr Treat Options Oncol,2003; 4(5)∶413.
2.	刘福坤,姚学权.胃癌的新辅助化疗[J].中国普外基础与临床杂志,2006; 13(1)∶18.
3.	Cheong JH,Shen JY,Song CS,et al.Early postoperative intraperitoneal chemotherapy following cytoreductive surgery in patients with very advanced gastric cancer[J].Ann Surg Oncol,2007; 14(1)∶61.
4.	詹文华.胃癌手术前化疗的研究现状[J].中华胃肠外科杂志,2005; 8(5)∶471.
5.	Frei E 3rd.Clinical cancer research:an embattled species[J].Cancer,1982; 50(10)∶1979.
6.	Cunningham D,Allum WH,Stenning SP,et al.Perioperative chemotherapy in operable gastric and lower oesophageal cancer:final results of a randomized controlled trial (the MAGIC trial,ISRCTN 93793971)[J].Proc Am Soc Clin Oncol,2005; 23∶308s.
7.	Wilke H,Preusser P,Fink U,et al.Preoperative chemotherapy in locally advanced and nonresectable gastric cancer:a phase Ⅱ study with etoposide,doxorubicin,and cisplatin[J].J Clin Oncol,1989; 7(9)∶1318.
8.	Yamaguchi K,Nakagawa S,Yabusaki H,et al.A case of advanced gastric cancer responding remarkably to paclitaxel + low-dose FP therapy in a neoadjuvant setting[J].Gan To Kagaku Ryoho,2006; 33(8)∶1163.
9.	Persiani R,D’Ugo D,Biondi A,et al.T-downstaging after neoadjuvant chemotherapy in locally advanced gastric carcinoma[J].Suppl Tumori,2005; 4(3)∶S88.
10.	Newman E,Marcus SG,Potmesil M,et al.Neoadjuvant ch-emotherapy with CPT-11 and cisplatin downstages locally advanced gastric cancer[J].J Gastrointest Surg,2002; 6(2)∶212.
11.	Lowy AM,Mansfield PF,Leach SD,et al.Response to neoadjuvant chemotherapy best predicts survival after curative resection of gastric cancer[J].Ann Surg,1999; 229(3)∶303.
12.	Koizumi W,Kurihara M,Nakano S,et al.Phase Ⅱ study of S-1,a novel oral derivative of 5-fluorouracil,in advanced gastric cancer.For the S-1 Cooperative Gastric Cancer Study Group[J].Oncology,2000; 58(3)∶191.
13.	Nakano K,Koizumi H,Okugawa K,et al.Evaluation of pre-operative administration of TS-1 in patients with advanced gastric or colorectal cancer--estimation of pathological effectiveness for postoperative adjuvant chemotherapy with TS-1[J].Gan To Kagaku Ryoho,2005; 32(3)∶329.
14.	Yoshida K,Ishikawa H,Sumida Y,et al.A case of N3 gastric cancer successfully treated by TS-1 followed by curative resection[J].Gan To Kagaku Ryoho,2006; 33(9)∶1321.
15.	Tsuchiya Y,Nashimoto A,Nakagawa S,et al.Advanced gastric cancer responding to pathological CR after neoadjuvant TS-1 combined with CDDP therapy--report of a case[J].Gan To Kagaku Ryoho,2006; 33(6)∶807.
16.	Nomura M,Inoue Y,Fujita S,et al.A case of gastric adenosquamous carcinoma with abdominal paraaortic lymph node metastases successfully treated by TS-1 plus CDDP neoadjuvant chemotherapy[J].Gan To Kagaku Ryoho,2006; 33(1)∶99.
17.	Mori S,Kishimoto H,Tauchi K,et al.Histological complete response in advanced gastric cancer after 2 weeks of S-1 administration as neoadjuvant chemotherapy[J].Gastric Cancer,2006; 9(2)∶136.
18.	Willett CG.Results of radiation therapy in gastric cancer[J].Semin Radiat Oncol,2002; 12(2)∶170.
19.	Klautke G,Foitzik T,Ludwig K,et al.Neoadjuvant radiochemotherapy in locally advanced gastric carcinoma[J].Strahlenther Onkol,2004; 180(11)∶695.
20.	Ajani JA,Mansfield PF,Janjan N,et al.Multi-institutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma[J].J Clin Oncol,2004; 22(14)∶2774.
21.	Mauera M,Harafd C,Ferguson K,et al.Docetaxel-based combined modality therapy for locally advance carcinoma of the esophagus and gastric carcinoma[J].Proc Am Soc Clin Oncol,2000; 19(6)∶954.
22.	Roth AD,Allal AS,Brundler MA,et al.Neoadjuvant radiochemotherapy for locally advanced gastric cancer:a phase Ⅰ-Ⅱ study[J].Ann Oncol,2003; 14(1)∶110.
23.	Lowy AM,Feig BW,Janjan N,et al.A pilot study of preoperative chemoradiotherapy for resectable gastric cancer[J].Ann Surg Oncol,2001; 8(6)∶519.
24.	Shchepotin IB,Chorny V,Hanfelt J,et al.Palliative superselective intra-arterial chemotherapy for advanced nonresectable gastric cancer[J].J Gastrointest Surg,1999; 3(4)∶426.
25.	吴鹏,朱正纲,叶正宝,等.5-氟尿嘧啶-2′-脱氧核苷经胃左动脉介入灌注后的药代动力学实验研究[J].外科理论与实践,2004; 9(2)∶135.
26.	蒲青凡,孙碎康,刘占培,等.术前胃动脉化疗栓塞对胃癌淋巴结转移灶癌细胞凋亡的影响[J].中国普外基础与临床杂志,2006; 13(4)∶427.
27.	王舒宝,王俊.胃癌复发与转移的有关问题及综合治疗[J].中国普外基础与临床杂志,2006; 13(1)∶9.
28.	孙建军,马建芳,陈少华.动脉灌注化疗联合栓塞治疗晚期胃癌[J].江西医学院学报,2006; 46(4)∶138.
29.	时桂兰,邢海凤,刘文昌,等.胃癌术前介入治疗的临床意义[J].现代医用影像学,2005; 14(4)∶165.
30.	Pestieau SR,Sugarbaker PH.Treatment of primary colon cancer with peritoneal carcinomatosis:comparison of concomitant vs.delayed management[J].Dis Colon Rectum,2000; 43(10)∶1341.
31.	Brenner B,Shah MA,Karpeh MS,et al.A phase Ⅱ trial of neoadjuvant cisplatin-fluorouracil followed by postoperative intraperitoneal floxuridine-leucovorin in patients with locally advanced gastric cancer[J].Ann Oncol,2006; 17(9)∶1404.
32.	Ceelen WP,Hesse U,de Hemptinne B,et al.Hyperthermic intraperitoneal chemoperfusion in the treatment of locally advanced intra-abdominal cancer[J].Br J Surg,2000; 87(8)∶1006.
33.	Pestieau SR,Schnake KJ,Stuart OA,et al.Impact of carrier solutions on pharmacokinetics of intraperitoneal chemotherapy[J].Cancer Chemother Pharmacol,2001; 47(3)∶269.
34.	Jansen M,Büchin P,Dreuw B,et al.Prognostic factors for development of peritoneal carcinosis in stomach carcinoma[J].Chirurgeon,2001; 72(5)∶561.
35.	Newman E,Potmesil M,Ryan T,et al.Neoadjuvant chemotherapy,surgery,and adjuvant intraperitoneal chemotherapy in patients with locally advanced gastric or gastroesophageal junction carcinoma:a phase Ⅱ study[J].Semin Oncol,2005; 32(6 Suppl 9)∶S97.
36.	梁寒,王仆,王晓娜,等.活性碳吸附丝裂霉素C腹腔化疗预防进展期胃癌术后复发[J].中华外科杂志,2003; 41(4)∶274.
37.	李琛.腹腔温热化疗的临床意义及其对机体生理功能的影响[J].外科理论与实践,1998; 3(1)∶48.
38.	Roviello F,Marrelli D,Neri A,et al.Treatment of peritoneal carcinomatosis by cytoreductive surgery and intraperitoneal hyperthermic chemoperfusion (IHCP):postoperative outcome and risk factors for morbidity[J].World J Surg,2006; 30(11)∶2033.
39.	Marutsuka T,Shimada S,Shiomori K,et al.Mechanisms of peritoneal metastasis after operation for non-serosa-invasive gastric carcinoma:an ultrarapid detection system for intraperitoneal free cancer cells and a prophylactic strategy for peritoneal metastasis[J].Clin Cancer Res,2003; 9(2)∶678.
40.	何涛,杨志明,伍晓汀.胃癌腹膜播散转移机理的研究进展[J].中国普外基础与临床杂志,2005; 12(1)∶45.
41.	De Roover A,Detroz B,Detry O,et al.Adjuvant hyperthermic intraperitoneal perioperative chemotherapy (HIPEC) associated with curative surgery for locally advanced gastric carcinoma.An initial experience[J].Acta Chir Belg,2006; 106(3)∶297.
42.	Yonemura Y,de Aretxabala X,Fujimura T,et al.Intraoperative chemohyperthermic peritoneal perfusion as an adjuvant to gastric cancer:final results of a randomized controlled study[J].Hepatogastroenterology,2001; 48(42)∶1776.
43.	朱正纲,汤睿.术中腹腔内温热化疗对进展期胃癌的临床疗效研究[J].中华胃肠外科杂志,2006; 9(1)∶26.
44.	Janunger KG,Hafstrom L,Glimelius B.Chemotherapy in gastric cancer:a review and updated meta-analysis[J].Eur J Surg,2002; 168(11)∶597.
45.	Valentini V,Cellini F,D’Angelillo RM.Combined treatments in gastric cancer:radiotherapy[J].Suppl Tumori,2003; 2(5)∶S39.
46.	季加孚主编.胃癌防治新观念[M].北京:人民军医出版社,2007∶1～4.
47.	Cunliffe WJ,Sugarbaker PH.Gastrointestinal malignancy:rationale for adjuvant therapy using early postoperative intraperitoneal chemotherapy[J].Br J Surg,1989; 76(10)∶1082.
48.	van Ruth S,Verwaal VJ,Hart AA,et al.Heat penetration in locally applied hyperthermia in the abdomen during intra-operative hyperthermic intraperitoneal chemotherapy[J].Anticancer Res,2003; 23(2B)∶1501.

1. <>[1]Higuchi K,Phan A,Ajani JA.Gastric cancer:advances in adjuvant and adjunct therapy[J].Curr Treat Options Oncol,2003; 4(5)∶413.
2. 刘福坤,姚学权.胃癌的新辅助化疗[J].中国普外基础与临床杂志,2006; 13(1)∶18.
3. Cheong JH,Shen JY,Song CS,et al.Early postoperative intraperitoneal chemotherapy following cytoreductive surgery in patients with very advanced gastric cancer[J].Ann Surg Oncol,2007; 14(1)∶61.
4. 詹文华.胃癌手术前化疗的研究现状[J].中华胃肠外科杂志,2005; 8(5)∶471.
5. Frei E 3rd.Clinical cancer research:an embattled species[J].Cancer,1982; 50(10)∶1979.
6. Cunningham D,Allum WH,Stenning SP,et al.Perioperative chemotherapy in operable gastric and lower oesophageal cancer:final results of a randomized controlled trial (the MAGIC trial,ISRCTN 93793971)[J].Proc Am Soc Clin Oncol,2005; 23∶308s.
7. Wilke H,Preusser P,Fink U,et al.Preoperative chemotherapy in locally advanced and nonresectable gastric cancer:a phase Ⅱ study with etoposide,doxorubicin,and cisplatin[J].J Clin Oncol,1989; 7(9)∶1318.
8. Yamaguchi K,Nakagawa S,Yabusaki H,et al.A case of advanced gastric cancer responding remarkably to paclitaxel + low-dose FP therapy in a neoadjuvant setting[J].Gan To Kagaku Ryoho,2006; 33(8)∶1163.
9. Persiani R,D’Ugo D,Biondi A,et al.T-downstaging after neoadjuvant chemotherapy in locally advanced gastric carcinoma[J].Suppl Tumori,2005; 4(3)∶S88.
10. Newman E,Marcus SG,Potmesil M,et al.Neoadjuvant ch-emotherapy with CPT-11 and cisplatin downstages locally advanced gastric cancer[J].J Gastrointest Surg,2002; 6(2)∶212.
11. Lowy AM,Mansfield PF,Leach SD,et al.Response to neoadjuvant chemotherapy best predicts survival after curative resection of gastric cancer[J].Ann Surg,1999; 229(3)∶303.
12. Koizumi W,Kurihara M,Nakano S,et al.Phase Ⅱ study of S-1,a novel oral derivative of 5-fluorouracil,in advanced gastric cancer.For the S-1 Cooperative Gastric Cancer Study Group[J].Oncology,2000; 58(3)∶191.
13. Nakano K,Koizumi H,Okugawa K,et al.Evaluation of pre-operative administration of TS-1 in patients with advanced gastric or colorectal cancer--estimation of pathological effectiveness for postoperative adjuvant chemotherapy with TS-1[J].Gan To Kagaku Ryoho,2005; 32(3)∶329.
14. Yoshida K,Ishikawa H,Sumida Y,et al.A case of N3 gastric cancer successfully treated by TS-1 followed by curative resection[J].Gan To Kagaku Ryoho,2006; 33(9)∶1321.
15. Tsuchiya Y,Nashimoto A,Nakagawa S,et al.Advanced gastric cancer responding to pathological CR after neoadjuvant TS-1 combined with CDDP therapy--report of a case[J].Gan To Kagaku Ryoho,2006; 33(6)∶807.
16. Nomura M,Inoue Y,Fujita S,et al.A case of gastric adenosquamous carcinoma with abdominal paraaortic lymph node metastases successfully treated by TS-1 plus CDDP neoadjuvant chemotherapy[J].Gan To Kagaku Ryoho,2006; 33(1)∶99.
17. Mori S,Kishimoto H,Tauchi K,et al.Histological complete response in advanced gastric cancer after 2 weeks of S-1 administration as neoadjuvant chemotherapy[J].Gastric Cancer,2006; 9(2)∶136.
18. Willett CG.Results of radiation therapy in gastric cancer[J].Semin Radiat Oncol,2002; 12(2)∶170.
19. Klautke G,Foitzik T,Ludwig K,et al.Neoadjuvant radiochemotherapy in locally advanced gastric carcinoma[J].Strahlenther Onkol,2004; 180(11)∶695.
20. Ajani JA,Mansfield PF,Janjan N,et al.Multi-institutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma[J].J Clin Oncol,2004; 22(14)∶2774.
21. Mauera M,Harafd C,Ferguson K,et al.Docetaxel-based combined modality therapy for locally advance carcinoma of the esophagus and gastric carcinoma[J].Proc Am Soc Clin Oncol,2000; 19(6)∶954.
22. Roth AD,Allal AS,Brundler MA,et al.Neoadjuvant radiochemotherapy for locally advanced gastric cancer:a phase Ⅰ-Ⅱ study[J].Ann Oncol,2003; 14(1)∶110.
23. Lowy AM,Feig BW,Janjan N,et al.A pilot study of preoperative chemoradiotherapy for resectable gastric cancer[J].Ann Surg Oncol,2001; 8(6)∶519.
24. Shchepotin IB,Chorny V,Hanfelt J,et al.Palliative superselective intra-arterial chemotherapy for advanced nonresectable gastric cancer[J].J Gastrointest Surg,1999; 3(4)∶426.
25. 吴鹏,朱正纲,叶正宝,等.5-氟尿嘧啶-2′-脱氧核苷经胃左动脉介入灌注后的药代动力学实验研究[J].外科理论与实践,2004; 9(2)∶135.
26. 蒲青凡,孙碎康,刘占培,等.术前胃动脉化疗栓塞对胃癌淋巴结转移灶癌细胞凋亡的影响[J].中国普外基础与临床杂志,2006; 13(4)∶427.
27. 王舒宝,王俊.胃癌复发与转移的有关问题及综合治疗[J].中国普外基础与临床杂志,2006; 13(1)∶9.
28. 孙建军,马建芳,陈少华.动脉灌注化疗联合栓塞治疗晚期胃癌[J].江西医学院学报,2006; 46(4)∶138.
29. 时桂兰,邢海凤,刘文昌,等.胃癌术前介入治疗的临床意义[J].现代医用影像学,2005; 14(4)∶165.
30. Pestieau SR,Sugarbaker PH.Treatment of primary colon cancer with peritoneal carcinomatosis:comparison of concomitant vs.delayed management[J].Dis Colon Rectum,2000; 43(10)∶1341.
31. Brenner B,Shah MA,Karpeh MS,et al.A phase Ⅱ trial of neoadjuvant cisplatin-fluorouracil followed by postoperative intraperitoneal floxuridine-leucovorin in patients with locally advanced gastric cancer[J].Ann Oncol,2006; 17(9)∶1404.
32. Ceelen WP,Hesse U,de Hemptinne B,et al.Hyperthermic intraperitoneal chemoperfusion in the treatment of locally advanced intra-abdominal cancer[J].Br J Surg,2000; 87(8)∶1006.
33. Pestieau SR,Schnake KJ,Stuart OA,et al.Impact of carrier solutions on pharmacokinetics of intraperitoneal chemotherapy[J].Cancer Chemother Pharmacol,2001; 47(3)∶269.
34. Jansen M,Büchin P,Dreuw B,et al.Prognostic factors for development of peritoneal carcinosis in stomach carcinoma[J].Chirurgeon,2001; 72(5)∶561.
35. Newman E,Potmesil M,Ryan T,et al.Neoadjuvant chemotherapy,surgery,and adjuvant intraperitoneal chemotherapy in patients with locally advanced gastric or gastroesophageal junction carcinoma:a phase Ⅱ study[J].Semin Oncol,2005; 32(6 Suppl 9)∶S97.
36. 梁寒,王仆,王晓娜,等.活性碳吸附丝裂霉素C腹腔化疗预防进展期胃癌术后复发[J].中华外科杂志,2003; 41(4)∶274.
37. 李琛.腹腔温热化疗的临床意义及其对机体生理功能的影响[J].外科理论与实践,1998; 3(1)∶48.
38. Roviello F,Marrelli D,Neri A,et al.Treatment of peritoneal carcinomatosis by cytoreductive surgery and intraperitoneal hyperthermic chemoperfusion (IHCP):postoperative outcome and risk factors for morbidity[J].World J Surg,2006; 30(11)∶2033.
39. Marutsuka T,Shimada S,Shiomori K,et al.Mechanisms of peritoneal metastasis after operation for non-serosa-invasive gastric carcinoma:an ultrarapid detection system for intraperitoneal free cancer cells and a prophylactic strategy for peritoneal metastasis[J].Clin Cancer Res,2003; 9(2)∶678.
40. 何涛,杨志明,伍晓汀.胃癌腹膜播散转移机理的研究进展[J].中国普外基础与临床杂志,2005; 12(1)∶45.
41. De Roover A,Detroz B,Detry O,et al.Adjuvant hyperthermic intraperitoneal perioperative chemotherapy (HIPEC) associated with curative surgery for locally advanced gastric carcinoma.An initial experience[J].Acta Chir Belg,2006; 106(3)∶297.
42. Yonemura Y,de Aretxabala X,Fujimura T,et al.Intraoperative chemohyperthermic peritoneal perfusion as an adjuvant to gastric cancer:final results of a randomized controlled study[J].Hepatogastroenterology,2001; 48(42)∶1776.
43. 朱正纲,汤睿.术中腹腔内温热化疗对进展期胃癌的临床疗效研究[J].中华胃肠外科杂志,2006; 9(1)∶26.
44. Janunger KG,Hafstrom L,Glimelius B.Chemotherapy in gastric cancer:a review and updated meta-analysis[J].Eur J Surg,2002; 168(11)∶597.
45. Valentini V,Cellini F,D’Angelillo RM.Combined treatments in gastric cancer:radiotherapy[J].Suppl Tumori,2003; 2(5)∶S39.
46. 季加孚主编.胃癌防治新观念[M].北京:人民军医出版社,2007∶1～4.
47. Cunliffe WJ,Sugarbaker PH.Gastrointestinal malignancy:rationale for adjuvant therapy using early postoperative intraperitoneal chemotherapy[J].Br J Surg,1989; 76(10)∶1082.
48. van Ruth S,Verwaal VJ,Hart AA,et al.Heat penetration in locally applied hyperthermia in the abdomen during intra-operative hyperthermic intraperitoneal chemotherapy[J].Anticancer Res,2003; 23(2B)∶1501.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Current Status of Multimodal Therapy for A vanced Gastric Carcinoma

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