晚期胃癌转化治疗的现状与临床问题
Current status and clinical issues of conversion therapy for advanced gastric cancer
李国新 1赵丽瑛 1梁华元1
作者信息
- 1. 南方医科大学南方医院普通外科,广州 510515
- 折叠
摘要
晚期胃癌异质性强、预后差,既往治疗策略以系统姑息治疗为主.转化治疗旨在对初始不可切除肿瘤经综合治疗后,降低肿瘤分期并完整切除肿瘤,从而改善患者预后.近期多项大型临床研究已证实免疫检查点抑制剂联合化疗可显著提高晚期胃癌的客观缓解率并延长生存时间.同时,随着多学科协作治疗的广泛开展和外科手术技术的进步,转化治疗在改善部分晚期胃癌患者的预后方面展现出巨大潜力.然而,由于晚期胃癌在局部分期、肿瘤转移部位和分子分型等方面极为复杂,其转化治疗仍存在诸多争议和尚待解决的问题.笔者深度剖析国内外胃癌转化治疗的相关研究进展,探讨晚期胃癌转化治疗的现状与临床问题.
Abstract
Advanced gastric cancer,characterized by high heterogeneity and poor prognosis,has traditionally been managed with a palliative care-centric comprehensive treatment.The concept of conversion therapy aims to reduce tumor staging and achieve complete tumor resection after comprehensive treatment of initially unresectable tumors,thereby improving patient prognosis.Recent large-scale clinical studies have demonstrated that immune checkpoint inhibitors combined with chemotherapy can significantly increase the objective remission rate and improve the survival of patients with advanced gastric cancer.Meanwhile,with the extensive development of multidisci-plinary teams and the advancement of surgical techniques,conversion therapy has shown great potential in improving the prognosis of advanced gastric cancer.However,due to the complexity of advanced gastric cancer in terms of local staging,metastatic sites,and molecular typing,there are still many controversies and unanswered questions in the field of conversion therapy.The authors systematically elaborate on the research progress of gastric cancer conversion therapy both domes-tically and internationally,and explore the current status and clinical issues of conversion therapy for advanced gastric cancer.
关键词
胃肿瘤/晚期/转化治疗/免疫治疗/多学科协作治疗Key words
Stomach neoplasms/Advanced/Conversion therapy/Immunotherapy/Multidisciplinary collaborative therapy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据