Chemistry of gastric carcinoma treats _'s treatment of the recommendation scheme

Chemistry of gastric carcinoma treats _'s treatment of the recommendation scheme
About the drug therapy of gastric carcinoma, the domestic expert, through discussing to communicate repeatedly on the basis of following medical science of card, of various fields to include gastric carcinoma assist chemotherapy, new auxiliary chemotherapy, recur to condone chemotherapy,etc., reach the preliminary common understanding gastric carcinoma of shifting etc. to the following.
Postoperative auxiliary chemotherapy
Multiple META analyze that verify postoperative auxiliary chemotherapy of gastric carcinoma more simple operation can be lengthened and survived to reduce to recur. Maintain postoperative generally so long as all internal organs function basically returns to normal, should carry on postoperative auxiliary chemotherapy as soon as possible, you had better begin aboutly at postoperative 4 week,should not over 8-12 week,might difficult to be bring by benefit of surviving in March such as exceeding. The course of treatment follows the medical basis of the card because not time limit, some experts propose continuing to use the experience of cancer of colon, suitable for June.
As to auxiliary for chemotherapy for scheme should according to pathology of patient by stages, operation way, high to last factor, states physical, last disease,etc. to choose, mainly including ECF (2A recommends) ,Fluorine urine pyrimidine medicine (including the card banks up his bank with earth) Jointly along platinum or sand favourable platinum (2A recommends) , uniting alkane of the Japanese yew (2B recommends) , the card banks up form medicine of his bank (2B recommends) with earth When. As to T3-4/N0-2M0 patient, especially endanger factor or the unstandard one of operation high, should try hard to adopt even the union schemes of three medicines of two medicines to carry on auxiliary chemotherapy.
New auxiliary chemotherapy
The main purpose of new auxiliary chemotherapy is pursued in short term tumour lowers one in order to improve the excising rate of operation, try hard to reduce the impact on patient's body and internal organs function in order to reduce and encloses operation period complication at the same time, so should be chosen the high-efficient and low-toxicity union chemotherapy scheme, avoid choosing single medicine. But the scheme including ECF (1 grade is recommended) that considers And derive scheme ECX, EOX, EOF (2A recommends) ,Fluorine urine pyrimidine medicine (including the card banks up his bank with earth) Jointly along platinum or sand favourable platinum (2A recommends) Or unite the Japanese yew alkane (2A recommends) When.
MAGIC test open the intersection of progress and issues of gastric carcinoma, enclose the intersection of operation and period new mode of chemotherapy, new auxiliary the intersection of union and auxiliary chemotherapy: Surgery each accepts 3 cycle ECF scheme chemotherapy from beginning to end, compared with the situation that simple surgery treats the group, not having obvious extension in disease life cycle to jointly treat the group, survival rate is obviously improved in 5, not recuring and shifting the risk to drop by 34%, the death risk drops by 25%. Research reveals new auxiliary chemotherapy can reduce some progress period gastric carcinoma T, N by stages, improve the effecting a radical cure rate of operation, enclose operation period chemotherapy can improve long-term survival rate. ECF scheme encloses the recommendation scheme of chemotherapy in period of operation as gastric carcinoma too.
Until new auxiliary chemotherapy propose chemotherapy carry on curative effect appraise soon 6 week in front of the skill, effective patient should according to the intersection of reaction and the intersection of decision and the intersection of surgery and opportunity to treat with patient by stages. If achieve the goal, should perform the operation as soon as possible, the operation is good that chemotherapy stops for 3-4 weeks.
Condoning chemotherapy of recuring and shifting gastric carcinoma
The chemotherapy purpose of a gastric carcinoma is the quality of making the life better and lengthens life cycle to develop, should be paid attention to high-efficient and safely when being chosen the scheme. Gastric carcinoma does not have a gleam of chemotherapy scheme of standard, daily scheme including ECF (1 grade is recommended) so far And derive scheme ECX/EOF/EOX (2A recommends) ,Fluorine urine pyrimidine medicine (including the card banks up his bank with earth) Uniting alkane of the Japanese yew is along platinum (1 grade is recommended) , or unite sand of favourable platinum (2A recommends) , unite along platinum (2A give a recommendation) . Iraq sets up it for the health for the base case (3 grades are recommended) ,Or the card banks up form medicine of his bank (2A recommends) with earth When.
In uniting the intersection of chemotherapy and scheme, ECF, DCF high-level to follow medical science of the card according to support already, NCCN gives a recommendation as a kind of scheme. The scheme evidence based on obeying favourable platinum of platinum, sand is more abundant too, and for a long time in our country's clinical practice. FP scheme is used in Asia area extensively, ML17032 test adopts the card to bank up his bank with earth and make up XP scheme and FP scheme and carry on contrast instead of 5FU, the two RR are 41% and 29%, TTP is 5.6 and 5.0 months, the bad reaction is similar. RR 45% of XP scheme in the clinical research of domestic many centre II stages which gold Mao Professor Lin of our country reported, OS December. ECF is a daily scheme in Europe, REAL2 studies and includes in 1002 period gastric carcinoma patients of progress, has compared ECF, EOF, ECX and four kinds of schemes of EOX, find the card banks up his bank with earth and is similar to 5FU, sand of favourable platinum and obeying platinum similarly, overall curative effect EOX preponderates even more than ECF. FOLFOX is a domestic and commonly used gastric carcinoma healing solution too, the card banks up his bank with earth and replaces XELOX scheme that 5FU makes up, study to report RR reaches 65%, there is very good application prospect in little sample. With how west the intersection of Japanese yew and the intersection of alcohol and first line it treats progress to be more in issues of research of gastric carcinoma abroad, by V325 (DXT +CDDP +5 - FU, DCF) of Ajani report Studying can be seen, RR 43%, TTP: 5.9m, OS: 9.6m, but 3/4 grades cell lower the incidence and is up to 75%. South Korea adopts the card to bank up his bank with earth and substitute 5FU in DCF scheme while studying, the result reveals RR improves to some extent, TTP is 7.8 months, life cycle is as long as 16.9 months in the location of China, the neutral cells of 3/4 grades reduced the incidence to drop to 40% notably. These preliminary research reveals, the card banks up the fine, malicious side effect of curative effect of his bank with earth littly, and it is convenient to unite with various medicines, it is expected to become one of the main choices of a gleam of chemotherapy of gastric carcinoma. But need more clinical verification too.
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