文档介绍：胃癌化疗现状与进展
王杰军
胃癌的流行病学
中国新发癌症病例
GLOBOCAN 2002. IARC CancerBase , V . IARCPress, Lyon, 2004.
3
中国癌症死亡病例
GLOBOCAN 2002. IARC CancerBase , V . IARCPress, Lyon, 2004.
可切除胃癌的术前化疗
MAGIC
ECF q21×3cs 手术 ECF q21×3cs
N=250
可切除胃癌(74%)
低位食管癌(14%) R
胃食管结合部(11%)
ECF:
N=253 单纯手术 E 50mg/m2
C 60mg/m2
FU 200mg/m2/d civ
Cunningham D, et al. Perioperative Chemotherapy versus Surgery
Alone for Resectable Gastroesophageal Cancer. N Engl J
;355(1):11-20.
MAGIC:无疾病进展生存率(PFS)
ECF+手术
hazard ratio = ;
95% CI: to ;
P<
MAGIC:总体生存率(OS)
ECF+手术
hazard ratio = ;
95% CI: to ;
P = ;
5-year survival rate:
36% vs. 23%
MAGIC:肿瘤大小与术后分期
ECF + Surgery Surgery
Size cm cm (p = )
T1 / T2 52% 38%
T3 / T4 48% 62% (p= )
N 0/1 84% 76%
N 2/3 16% 24% (p = )
MAGIC 结论
•对于可手术胃癌和低位食管腺癌患者,
ECF+手术与单纯手术相比:
–缩小肿瘤大小
–降低术后分期
–显著提高PSF
–显著提高OS