胃癌术后临床试验课件.ppt

胃癌术后治疗相关临床试验;主要临床试验;NCCN指南;NCCN指南; assigned patients： → perioperative chemotherapy and surgery (250 patients) Chemotherapy ：3*ECF preoperative + 3*ECF postoperative ECF ：epirubicin (50 mg/m2)；cisplatin (60 mg/m2) ；fluorouracil (200 mg/m2) for 21 days. →surgery alone (253 patients). The primary end point was overall survival. --- N Engl J Med. 2006 Jul 6;355(1):11-20.;围手术期化疗-MAGIC试验;术后辅助化疗;术后辅助化疗--ACTS-GC;3y os：80.1% vs 70.1% ;术后辅助化疗--CLASSIC;(520);术后辅助放化疗--INT-0116（SWOG 9008）;OS：36m vs 27m; This update, presents data on failure patterns、second malignancies 、explores selected subset analyses. Second malignancies were observed in 21 patients with radiotherapy versus eight with observation (P = .21). Subset analyses show robust treatment benefit in most subsets, exception of patients with diffuse histology who exhibited minimal nonsignificant treatment effect ---J Clin Oncol. 2012 May 14. ;术后辅助放化疗--ARTIST;lymph node–positive patients.;DFS according to stage (multivariate analysis).;NCCN指南;转移性或局晚的根治性化疗--SPIRITS;S-1+D :13.0 months S-1: 11.0 months ; S-1+D :6.0 months S-1: 4.0 months ;转移性或局晚的根治性化疗--real-2; capecitabine fluorouraci median survival (M) 10.9 9.6 1-year survival rate 44.6% 39.4%;转移性或局晚的根治性化疗--real-2;转移性或局晚的根治性化疗--TOGA;HER2-positivity rate of 22.1% evaluated from 3807 patients. The HER2-positivity rate was similar between Europe (23.6%) and Asia (23.5%). HER2-positivity rates were higher in gastro-oesophageal junction (GEJ) than stomach cancer (33.2% vs 20.9%; p0.001) and in intestinal than diffuse/mixed cancer (32.2% vs 6.1%/20.4%; p0.001).;转移性或局晚的根治性化疗--TOGA