Incidence of gastric cancer is ranked
fourth in the most common malignancy in the world, there are about 1 million of
the new cases annually. Ranks second in male cancer mortality, fourth in the
ranks among women. As we all know, the adequacy of local control is the key to
treat gastric cancer. The incidence rate of the incidence of primary gastric
cancer liver metastases is 4% to 14%. Gastric cancer liver metastases is still
incurable, patients with 5-year survival rate is only 10%.
Gastric cancer liver metastases, often
accompanied with peritoneal dissemination, lymph node metastasis or tumor
direct violation of other organs, so few reports about the resection of liver
metastases of gastric cancer. Compared with colorectal cancer, the vast
majority of gastric cancer liver metastases often prompts the disease has been
widely spread. A report shows that in gastric cancer patients with liver
metastases, only 1/5 of the patients line liver metastases resection. The
survival rate of liver resection is relatively poor, 2/3 of patients with
intrahepatic recurrence. Such a high relapse rate in surgery within 2 years
means that there is a potential intrahepatic metastases in hepatectomy.
According to pharmaceutical raw materials suppliers,
many new drugs such as oxaliplatin, taxane, irinotecan and S-1 and so on for patients
with advanced gastric cancer provide a more effective and safe treatment
option. Studies have shown that the effective rate of 5-FU + calcium folinate
(CF) with oxaliplatin combination chemotherapy is 38% to 54%, overall survival is
8 to 11 months, and good security. The effective of taxane treat advanced
gastric cancer was 11% to 24%. Another study showed that single-agent
irinotecan in the treatment of gastric cancer was 20%. Various chemotherapy containing
irinotecan showed a better relieve rate. What’s more, the irinotecan
price is moderate, can be widely
used.
S-1 is a fluorouracil derivative oral
anticancer drug, compared with 5-FU has the following advantages: (1) can
maintain a high blood concentration and improve anticancer activity; (2)
significantly reduce drugtoxicity; (3) getting drugs convenient. In Japan, S-1 in 1999, has been approved it in the
treatment of advanced gastric cancer. In Japan, more than 80% of the advanced
gastric cancer chemotherapy use the S-1, its efficiency up to 44.6%. Clinical
trials have shown that the effective rate of S-1 for gastric cancer with liver
metastasis was 25% to 31%.
Recently, a clinical trial conducted by
oncologists show that S-1 single-agent efficacy was not inferior to 5-FU alone
drug; irinotecan combined with cisplatin was no better than use 5-FU alone. Analysis
showed that irinotecan can significantly prolonged progression-free survival
and overall survival associated with liver metastasis or lymph node metastasis
in patients with irinotecan plus cisplatin. In addition, studies have shown
that the first-line treatment for advanced gastric cancer, S-1 plus cisplatin is
more effective than the S-1 single drug. Therefore, S-1 plus cisplatin has
become one of the standard first-line treatment of advanced gastric cancer
program in Japan.
In S-1 combined with docetaxel clinical trials, types and histopathological
types of gastric cancer involving the organ does not affect the efficacy of the
program, wherein the overall response rate of gastric cancer liver metastases
was 64.7%.
In addition, countries in the treatment of
advanced gastric cancer chemotherapy are not the same. Such as the United States is often used docetaxel +
cisplatin +5- FU, Europe often used epirubicin + cisplatin +5- FU or epirubicin
+ oxaliplatin + capecitabine, while South Korea is recommended cisplatin +
capecitabine. But the efficacy of the above methods in gastric metastasis has
not been reported.
Source:http://www.cospcn.com
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