Gastric Cancer: Natural History and Treatment

[摘要] In this thesis we have defined the group of patients with gastric cancer who do well after surgical resection. Patients in whom the tumour has penetrated the serosa do badly, even if they have an apparently curative resection. For this group of patients, surgery alone is insufficient treatment and some form of adjuvant therapy is clearly required. The best candidate at the moment is chemotherapy but so far the results of adjuvant chemotherapy have been disappointing. Another possible approach involves the use of intraperitoneal chemotherapy given in the adjuvant setting because as outlined in Chapter Two, tumours which have penetrated the serosa are often associated with free cancer cells in the peritoneum. Cisplatin, one of the most active drugs in gastric cancer, has been given by the intraperitoneal route to treat ovarian cancer but not gastric cancer. This route of administration effectively delivers 15 times the equivalent intravenous dose to the peritoneum and because it is absorbed via the peritoneum it also has a systemic effect (216). This systemic effect would be necessary to eradicate micrometastatic disease outwith the peritoneum.

[发布机构] University:University of Glasgow

[关键词] Medicine, Oncology