NCCN胃癌临床实践指南中国版解读-沈琳演示幻灯片.pptVIP

A superior response rate was observed for Xeloda/cisplatin vs. 5-FU/cisplatin (p=0.030), supporting the general trend to superiority seen in other efficacy endpoints. Tumor responses were assessed according to Response Evaluation Criteria in Solid Tumors (RECIST) specifications. Overall response is the sum of confirmed complete and partial responses. Three complete responses were observed in Xeloda/cisplatin groups vs. 4 complete responses in the 5-FU/cisplatin group. Patients in the Xeloda/cisplatin group had 1.4 times the chance of achieving an overall response compared to patients in the 5-FU/cisplatin group. The results of an independent review did not contradict these findings. 2008.v.1NCCN guideline : Recommendation of Chinese version: To add cisplatin plus fluoropyrimidine(5-FU or capecitabine) category 2B To add fluoropyrimidine (5-FU or capecitabine) for old patients or poor performance status. Category 2B GAST-C 1 of 2: metastatic or locally advanced cancer GAST-C 1 of 2: preoperative chemoradiation Docetaxel might be changed; Category 2B to 3. GAST-3:T3,T4 or any T,N1 after R0 resection Add foot note: If D0/D1 resection: agreed the above(CT+RT); If D2 resection: postoperative chemotherapy recommended. GAST-C 1 of 2: postoperative chemotherapy To add S-1 (category 2B) with footnote (not availabe in market now) GAST-3：after R1 resection To add “Clinical trials” as another option. GAST-C 1 of 2: metastatic or locally advanced cancer DCF modification： PF/DF/wDCF/DC/DX/PX should be added category 2B To add cisplatin plus fluoropyrimidine(5-FU or capecitabine) category 2B To add fluoropyrimidine (5-FU or capecitabine) for old patients or poor performance status. Category 2B Recommendation of Chinese version: 概念的更新：在整个治疗指南中将chemotherapy/RT更改为chemoradiation，salvage 改为palliative 强调多学科协作在胃癌综合治疗中的重要地位，要求多学