[基础医学]晚期胃癌2011.pptVIP

Thank You For Your Attention! * Countries with highest prevalence of gastric cancer are highlighted in yellow based on age standardized incidence risk (ASR) in men 20 / 100 000 by region [1]. Regions highlighted in green represent countries with ASR for gastric cancer in men ≥10 and ?20 / 100 000. Regions highlighted in cyan (light blue) represent countries with a low incidence of gastric cancer (ASR in men 10 / 100 000). Approximately two-thirds of gastric cancer cases occur in less developed countries with the highest incidence rates in the Asia-Pacific region. Areas with the highest incidence of gastric cancer include Japan, China, Korea, Central and South America, Eastern Europe, and the Middle East. Japan has the highest incidence rate for gastric cancer in the world (62.1 ASR in men / 100 000). The majority of gastric cancer cases (42%) occur in China [2]. There is a low incidence rate in North America, Northern Europe, Australia/New Zealand, and India [1,2]. In the US, there are approximately 22 000 new cases of gastric cancer diagnosed per year [3]. Worldwide: 900 000 new cases and 700 000 deaths per year due to gastric cancer. 5-year survival-rate for gastric cancer is ?20%. gastric cancer is the second leading cause of cancer death in the world [2]. 1. Parkin DM et al. CA Cancer J Clin 2005;55:74–108. 2. Yang L. World J Gastroenterol 2006;12;17–20. 3. . 此处MTD为再敲回车出现 * * 今天我们主要来看一下在晚期胃癌治疗中肿瘤内科的治疗手段－化疗 * * * * * ML17032试验设计：本试验为一项开放、随机的国际多中心III期临床试验，有包括了中国在内的13个国家、46个中心注册参与。目的是比较希罗达? /顺铂联合化疗方案及5-FU/顺铂联合化疗方案治疗进展性/转移性胃癌的疗效。 该试验共入选晚期胃癌患者316例，随机分成两组，其中希罗达? /顺铂组160例， 5-FU/顺铂156例。入选标准为既往未针对进展性/转移性胃癌进行过治疗、有一个或以上可测量的转移性病灶；疗效按照RECIST标准（实体瘤治疗反应评价标准）来评定。 试验剂量分别为：顺铂：80mg/m2，静脉输注3小时，需要水化，D1 ； 希罗达? ：2000mg/m2/d，分两次口服，D1-14，q3w； 5-FU： 800mg/m2/d，静脉持续输注，D1-5，q3w； 试验的主要目的：验证希罗达? /顺铂方案的无进展生存期（PFS）不亚于5-FU/顺铂联合化疗方案。 * 试验中观察到： XP方案的有效率优于FP方案（XP方案总有效率为41%，FP方案总有效率为29%；p=0.03，结果具有统计学差异）。XP组总有效率约为FP组的1.4倍；两组取得疾病稳定的患者