Post-operative and Preoperative Adjuvant Chemotherapy for Gastric Cancer Inspection of Efficacy Atsushi Nashimoto 1 1Division of Surgery, Niigata Cancer Center Hospital Keyword: 術後補助化学療法 , メタアナリシス , 術前化学療法 , 臨床試験 pp.999-1013
Published Date 2005/6/25
DOI https://doi.org/10.11477/mf.1403100217
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A relatively large scale randomized clinical trial(RCT)could not prove a favorable survival advantage for patients with gastric cancer(GC), though several meta-analyses in Western countries revealed evidence of the survival benefit of postoperative adjuvant chemotherapy(CTx). In Japan, JCOG' RCTs of adjuvant chemotherapy for serosa-negative or serosa-positive GC after curative surgery hasn't been able to improve the survival benefit. Therefore, there is no recommending standard therapy for postoperative adjuvant chemotherapy(CTx). As a preoperative adjuvant CTx, preoperative radiochemotherapy for initially incurable advanced GC was proved in the USA. After the MAGIC trial in Europe, large scale phase III trials have been on-going in order to prove the advantage of preoperative adjuvant CTx. Even in Japan, the appearance of new anticancer drugs and intensive chemotherapy regimens could reduce staging and improvement of survival. TS-1+CDDP, which has confirmed feasibility and sufficient efficacy, is one of the most expected regimens. There seems to be a tendency towards a paradigm shift from postoperative to preoperative CTx as new RCTs, in order to avoid the low compliance of postoperative adjuvant CTx.

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