Though the global outbreak rate of stomach cancer has to descend, stomach cancer still for threaten mankind one of the main malignant tumors of the life.Currently, the surgical operation treatment is still cure for good of stomach cancer a method.Early diagnose the exaltation of rate because of the stomach cancer in Japan, Korean etc. nation, make the long-term existence period of stomach cancer have bigger improvement;However our country and western nation be about above 80% of stomach cancer sufferer while discover already in order to make progress period or later period, the pure surgical operation cures its effect worse, or can’t surgical operation, for later period can’t the surgical operation cut off of or cure for good after operation partial relapse to transfer with distance of and be taken bad to change scope more wide at first, and have already had district the lymphoid knot transfer of stomach cancer sufferer, the chemotherapy is still a main treatment method.Few decade-old clinical research, the agree with stomach cancer chemotherapy has already acquired abundant experience, the curative effect of the consociation chemotherapy is continuously raising, particularly was in recent years to discover some new medicines which have a special function mechanism, and the curative effect has already included an obvious exaltation.
One assistance chemotherapy
As early as 1957, in the United States agree with stomach cancer Shu future trouble use a single medicine 5 FUs Be assistance treatment, but relatively have no existence period to improve with the sufferer of pure surgical operation.Immediately applied project(me CCNU, 5 FUs, ADM) with the second nitric Mao(me CCNU), project(list use MMC, or unite 5 FUs, UFT, Ara C) with the silk crack mildewed vegetable(MMC), contain mildewed vegetable(ADM) of project.(FAM or unite 5 FUs)These projects are in the stomach cancer the assistance the chemotherapy, great majority clinical trial express, have several Japanese clinical trials to hint that lending support to a chemotherapy an agree with stomach cancer sufferer is beneficial towards improving existence to expect to have no influence only.Some scholars think that time of beginning of assistance chemotherapy is very important, theoretically should as early as possible carry on, clinical top generally not exceed after the Shu 4 week is good.Japan and report way in Korea the immunity chemotherapy of the stomach cancer assistance expect beneficial place towards raising existence.
2 new ssistance chemotherapy
Because after the stomach cancer Shu lend support to chemotherapy improvement’s existence to expect not exert person’s idea, some scholars try application before the Shu the chemotherapy(new assistance chemotherapy) exist a period by raising rate and improvement of the surgical operation excision, but currently mainly for the clinical Ⅱ period experiment research result.New ssistance chemotherapy(project EAP, FP, FAMTX)’s ising efficient is 30%~68%, can cut off the rate as 8% for can’t the sufferer of the surgical operation chemotherapy empress~73%, can cut off the rate as 59% for limitting progress to expect sufferer~80%, can cut off a rate 66% for can the sufferer of surgical operation~72%.New ssistance the advantage of the chemotherapy:Can reduce the increment surgical operation of the tumor burden excision rate;Can with clearance small transfer a focus;The experiment discover that the surgical operation can induce an increase of survive focus to living but make the tumor cell bear chemotherapy medicine a medicine;Ex- the surgical operation tumor supply blood vessel integrity make the chemotherapy medicine well kill wound tumor cell, its weakness is:The sufferer delays a surgical operation treatment because of the toxicity of chemotherapy medicine;The ill rate of possible increment surgical operation.Currently still have no the Ⅲ expect the clinical trial manifestation to lately lend support to a chemotherapy and can improve an existence period, so new assistance the chemotherapy be still placed in a clinical trial stage, and strict choice sufferer.Because new ssistance chemotherapy stomach cancer the sufferer be after operation partial to relapse a rate higher, in recent years, some scholars are applied to lately lend support to a chemotherapy to add a new assistance to put to treat treatment stomach cancer and especially the cancer its curative effect of the stomach bottom Ben door make the person pay attention to.
3 appease a chemotherapy
Traditional the chemotherapy medicine be efficient>10%ly have 5 FUs, MMC, ADM, EPI, BCNU, DDP, MTX, Vp 16 with Qian Ji Mao.United a chemotherapy to unite MeCCNU or BCNU, but compare existence period with 5 FU single medicines to have no improvement for 5 FUs in early days.FAM(5 FUs, ADM, MMC) from extensively use at the beginning of 80’s in 20 centuries of the chemotherapy project of the stomach cancer consociation, efficient is 12%~65%, medium the existence expect for 5 months~9 months, but single medicine 5 FU the Ⅲ expect the FAM in the clinical trial to the influence which exists a period have no advantage.90’s in 20 centuries after, FAM project drive many projects with better curative effect such as EAP, ELF, ELFP, FAMTX, FP etc. replace, its curative effect included a further exaltation.These projects mostly have the characteristics of three aspects:With 5 FUs continuously infuse to note for foundation, 5 dependence medicine, continuously infuse to note is that the toxicity is aer little to use to the very high quantity machine’s body’s ability still good bear to be subjected to.For example:FP(5 FUs, DDP), ECF(Epirubicin, DDP, 5 FUs), FLP(5 FUs, LV, DDP)…etc..In these projects, 5 FUs can use one 000 mgs/(m 2 · ds)continuously infuse to note a 120 hs.(5 ds)Project with the DDP, have with much medicine to be in conjunction with function and marrow toxicity because of the DDP small, can constitute many different medicine projects, like FP, FLP, EAP etc..Among them EAP(VP 16, ADM, DDP) curative effect although good, efficient and tallest can reach to 64%, the CR can reach to 21%, because of treatment toxicity big, can cause the report increment for die, its toxicity should cause a value.Use four hydrogen folic acid(Leucovorin, CF, LV)s or MTX a big quantity conduct and actions 5 FU bio-chemical regulate a project of increase the effect.Because give big quantity CF behind can stabilize and increase three heavy compound formations, sour to chest Mao synthesize repress of Mao(TMPS), the function consumedly strengthens, but before 5 FUs use first quantity MTX can cause the phosphoric acid in the cell check a sugar double store of phosphoric acid salt(PRPP) in etc., help the cell toxicity function of 5 FUs to strengthen, the main project contains ELF, FLEP, FAMTX etc..In recent years, the lately- develop anti-cancer new medicine,such as Tai Suo Di(Taxoere), Tai vegetable(Taxol), Yi, signs to choose(Gemcitabine) a single medicine an agree with stomach cancer for the Kang(CPT 11), Jian objective and efficient have an exaltation, express better curative effect.Regardless Be a glimmer of medicine still two line medicines, it the single medicine be efficient to all attain 15% ～s 24%.In 2 the period the research, researcher’s discovering them has never cross with other medicine to bear a medicine and layer after layer of toxicity respond, so they wet yew Chun and fluorine Mi Ding 2 chemotherapy project of the platinum consociations to apply in make progress period the stomach cancer sufferer’s assistance chemotherapy in.Yew Chun and platinum medicine suitable for use has to be in conjunction with a function.The yew Chun amiable platinum or yew Chun and 52 FUs of efficient attain 22% ～s 65%, the medium existence expects for 10 months(6 months with 14 month ～s).
3.1 cells poisonous medicine Pei beautiful song fill(pemetrexed) is a kind of many Bas the product repress various Maos to include chest Mao in the folic acid the metabolism toward the anti- folic acid sour synthesize Mao, two hydrogen folic acid revivification Maos, A Mao Ji sweet ammonia Mao An pit the Mao be sour to transfer Mao, the A Mao Ji ammonia Ji Mi Shi ammonia A Mao Ji pit sugar pit the Mao be sour to transfer Mao.The Pei beautiful song’s fill is single medicine, measures for the 2,21 ds/1 of the 500 mgs/m a time and apply in make progress the stomach cancer sufferer whom period or companion transfer, the Ⅱ expects to test a result to show that alleviating a rate attains 28%.
3.2 arouse Mao depressant moss to suppress vegetable(bryostatin) egg white to arouse Mao C(PKC) is Mao that a the tribe fat dependent film lies to lead, play important role in the cell the conduction the thoroughfare.The moss suppresses a vegetable 1(bryostatin 1) have already regulated an effect in the PKC lie lead of the cell biology.It to mankind cancer cell the stub contain direct cell poisonous function, regulate a few functions with poisonous cells of chemotherapy medicine inside the tube, Be single medicine to make progress period stomach cancer invalid, but with agreeable platinum allied use is 1 kind to more and so alleviate to regulate.The Flavopiridol Flavopiridol is a kind of CD K in the clinical studies depressant.It represses cell to propagate a period, induce Diao Wu, promote to divide and repress an afferent growth.Give in the first clinical studies the Flavopiridol be all valid to lymphoid lump, kidney, colon, stomach tumor.The toxicity is diarrhea, there is also low blood pressure, pass the appropriate control is to prevent°from Flavopiridol can also allied with other chemotherapy medicine use, include Yi to sign substitute Kang, agreeable platinum with many west yew Chun.
3.3 wreaths oxidize Mao 22(COX22) depressant Epidemiologies to all confirm that the COX22 may be an important treatment Ba to order with clinical researches.The selectivity COX22 depressant, for example the nime 2 sulides confirms to have already successfully prevented You door from Luo rod bacteria to infect related stomach cancer through the animal experiment.
4 belly cavity chemotherapies
The belly cavity transfers into stomach cancer after cure for good the Shu of most familiarly relapse a form, so surgical operation in or after operation the belly cavity chemotherapy has been research of a little bit hot, however pure of belly cavity chemotherapy income not big, applied the belly cavity hot chemotherapy to show certain curative effect in recent years, particularly the that day originally keeps on belly cavity to warm up to infuse to note(CHPP) a chemotherapy, in common use medicine is DDP, 5 FUs, MMC.Japan leads off belly cavity in the stomach cancer surgical operation to apply MMC and live Tan or pure surgical operation, the existence for treatment set 3 years expects to 66% in 113 sufferers obviously high at the matched control(22%), covariance’s learning difference has already shown Zhao.(P<0.01)Immediately confirmed that result, but many center clinical trials in Europe discover that square magic trick behind of the complications obviously rises and the belly cavity chemotherapy is still placed in a clinical trial research a stage
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