Journal of Digestive Cancer Research

  • 제2권2호
  • /
  • Pages.45-51
  • /
  • 2014
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  • 2950-9394(pISSN)
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  • 2950-9505(eISSN)
대한소화기암연구학회 (Korean Society of Gastrointestinal Cancer Research)
권호 표지

진행성 위암에서의 항암요법에 대하여

Palliative and Neoadjuvant Chemotherapy for Advanced Gastric Cancer Patients

  • 문희석 (충남대학교 의과대학 내과학교실)
  • Hee Seok Moon (Department of Internal Medicine, Chungnam National University School of Medicine)
  • 투고 : 2014.12.01
  • 심사 : 2014.12.26
  • 발행 : 2014.12.31
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초록

Gastric cancer is the second most common cancer and the third leading cause of cancer-related deaths in Korea. Many cases of gastric cancer are detected in the early stages on standard medical examinations; complete surgical and endoscopic resection is the most recommended treatment for early-stage gastric cancer. Nevertheless, many patients have already progressed to advanced gastric cancer (AGC) upon diagnosis, and the prognosis of such patients is very poor. Combination chemotherapy has been shown to produce a better quality of life (QOL) and to increase overall survival in AGC patients. However, approximately 50% of patients do not respond to the current first-line chemotherapy, while most patients who do respond eventually show disease progression. Accordingly, various second-line regimens have been investigated, and active salvage chemotherapy has been shown to improve the QOL and clinical outcomes in select AGS patients who can tolerate it. There is also an increasing need for neoadjuvant therapy for treating gastric cancer; therefore, various clinical trials have been set up to investigate different regimens. Neoadjuvant therapy is currently established as the standard treatment for locally AGC in Europe; it has contributed to lowering the nodal stages and has reduced overall mortality rates. Despite these benefits, many uncertainties remain. Therefore, further prospective, high quality randomized controlled trials for neoadjuvant therapies are needed to clarify their clinical benefits and to establish the most effective treatment strategies for AGC.

키워드

참고문헌

  1. World Cancer Research Fund International. Cancer frequency by country, Source: GLOBOCAN 2008 database (version 1.2) [Internet]. London: World Cancer Research Fund International; 2008 [updated 2014 Feb 14]. Available from: www.wcrf.org.
  2. Webb A, Cunningham D, Scarffe JH, et al: Randomized trial comparing epirubicin, cisplatin and fluorouracil versus fluorouracil, doxorubicin and methotrexate in advanced esophagogastric cancer. J Clin Oncol 1997;15:261-267.
  3. Boku N, Yamamoto S, Fukuda H, et al. Fluorouracil versus combination of irinotecan plus cisplatin versus S-1 in metastatic gastric cancer: a randomized phase 3 study. Lancet Oncol 2009;10:1063-1069.
  4. Koizumi W, Narahara H, Hara T, et al. S-1 plus cisplatin versus S-1 alone for first line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol 2008;9;215-221.
  5. Ajani JA, Rodriguez W, Bodoky G, et al: Multicenter phase III comparison of cisplastin/S-1 with cisplatin/infusionla fluorouracil in advanced gastric or gastroesophageal adenocarcinoma study: the FLAGS trial. J Clin Oncol 2010;28:1547-1553.
  6. Kang YK, Kang WK, Shin DB, et al. Capecitabine/cisplatin versus 5-fluorouracil/cisplatin as first line therapy in patients with advanced gastric cancer: a randomised phase III non-inferiority trial. Ann Oncol 2009;20:666-673.
  7. Cunningham D, Starling N, Rao S, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med 2008;358:36-46.
  8. Al-Batran SE, Hartmann JT, Probst S, et al. Phase III trial in metastatic gastroesophageal adenocarcinoma with fluorouracil, leucovorin plus either oxaliplatin or cisplatin: a study of the Arbeitsgemeinschaft Internistische Onkolgie. J Clin Oncol 2008;26:1435-1442.
  9. Van Cutsem E, Moiseyenko VM, Tjulandin S, et al. Phase III study of docetaxel and cisplastin plus fluorouracil compared with cisplatin and fluorouracil as first line therapy for advanced gastric cancer: a report of the V325 Study Group. J Clin Oncol 2006;24:4991-4997.
  10. Kang JH, Lee SI, Lim DH, et al. Salvage chemotherapy for pretreated gastric cancer: a randomized phase III trial comparing chemotherapy plus best supportive care alone. J Clin Oncol 2012;30:1513-1518.
  11. Cook N, Marshall A, Blazeby JM, et al. A randomized phase III study of docetaxel versus active symptom control in patients with relapsed esophago-gastric adenocarcinoma. J Clin Oncol 2013;31(Suppl abstr 4023).
  12. Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomized controlled trial. Lancet 2010;376:687-697.
  13. Lordick F, Kang YK, Chung HC, et al. Capecitabe and Cisplatin with or without cetuximab for patients with previously untreated advanced gastric cancer (EXPAND): a randomised, open labe phase 3 trial. Lancet Oncol 2013;14:490-499.
  14. Ohtsu A, Shah MA, Van Cutsem E, et al. Bevacizumab in combination with chemotherapy as first line therapy in advanced gastric cancer: a randomized double placebo- controlled phase III study. J Clin Oncol 2011;29:3968-3976.
  15. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006;355:11-20.
  16. Ychou M, Boige V, Pignon JP, Conroy T, Bouche O, Lebreton G, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol 2011;29:1715-1721.
  17. Schuhmacher C, Gretschel S, Lordick F, Reichardt P, Hohenberger W, Eisenberger CF, et al. Neoadjuvant chemotherapy compared with surgery alone for locally advanced cancer of the stomach and cardia: European Organisation for Research and Treatment of Cancer randomized trial 40954. J Clin Oncol 2010;28:5210-5218.