胃癌新輔助化療療效臨床評價方法及進展_《中國普外基礎與臨床雜志》

作者：

汪劭婷 ¹ , 朱朝暉 ² , 李小毅 ³

1.中國醫學科學院北京協和醫學院（北京 100730）;;
2.北京協和醫院核醫學科PET中心（北京 100730）;;
3.北京協和醫院基本外科（北京 100730）;

關鍵詞：

胃癌新輔助化療療效評價正電子發射電子計算機斷層

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的研究胃癌新輔助化療療效臨床評價方法及進展。
方法對有關胃癌新輔助化療療效臨床評價方法的文獻進行綜述分析，比較CT、EUS、MRI及PET的評價結果與術后病理、預后結果的符合度。
結果 CT、EUS是目前臨床中常用的療效評價方法，但是其評價指標和標準不統一, 胃癌套用現有的實體瘤療效評價標準似乎并不適用; 采用磁共振擴散加權成像（DWI）評價胃癌新輔助化療療效還有待進一步研究; PET在早期準確篩選出化療無效病例方面具有優勢。
結論胃癌新輔助化療療效臨床評價尚缺乏統一標準，各種影像學方法的綜合應用可能有利于提高評價的準確性。

引用本文： 汪劭婷,朱朝暉,李小毅. 胃癌新輔助化療療效臨床評價方法及進展. 中國普外基礎與臨床雜志, 2010, 17(2): 200-204. doi: 復制

1.	Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer [J]. N Engl J Med, 2006; 355(1): 1120.
2.	Boige V, Pignon J, SaintAubert B, et al. Final results of a randomized trial comparing preoperative 5fluorouracil (F)/cisplatin (P) to surgery alone in adenocarcinoma of stomach and lower esophagus (ASLE): FNLCC ACCORD07FFCD 9703 trial [J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4510.
3.	方育, 王亞軍, 李非, 等. 奧沙利鉑聯合甲酰四氫葉酸鈣和氟尿嘧啶新輔助化療方案治療進展期胃癌的研究 [J]. 中華胃腸外科雜志, 2006; 9(6): 510512.
4.	National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Gastric cancer (NCCN).v.2. 2009. http://www.nccn.org/professionals/physician_gls/PDF/gastric.pdf.
5.	Ninomiya Y, Yanagisawa A, Kato Y, et al. Histological indications of a favorable prognosis with faradvanced gastric carcinomas after preoperative chemotherapy [J]. J Cancer Res Clin Oncol, 1999; 125(12): 699706.
6.	Becker K, Mueller JD, Schulmacher C, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy [J]. Cancer, 2003; 98(7): 15211530.
7.	Weber WA, Ott K, Becker K, et al. Prediction of response to preoperative chemotherapy in adenocarcinomas of the esophagogastric junction by metabolic imaging [J]. J Clin Oncol, 2001; 19(12): 30583065.
8.	Ott K, Fink U, Becker K, et al. Prediction of response to preoperative chemotherapy in gastric carcinoma by metabolic imaging: results of a prospective trial [J]. J Clin Oncol, 2003; 21(24): 46044610.
9.	Ott K, Weber WA, Lordick F, et al. Metabolic imaging predicts response, survival, and recurrence in adenocarcinomas of the esophagogastric junction [J]. J Clin Oncol, 2006; 24(29): 46924698.
10.	Lordick F, Ott K, Krause BJ, et al. PET to assess early metabolic response and to guide treatment of adenocarcinoma of the oesophagogastric junction: the MUNICON phase Ⅱ trial [J]. Lancet Oncol, 2007; 8(9): 754755.
11.	Miller AB, Hoogstraten B, Staquet M, et al. Reporting results of cancer treatment [J]. Cancer, 1981; 47(1): 207214.
12.	Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors [J]. J Natl Cancer Inst, 2000; 92(3): 205216.
13.	Young H, Baum R, Cremerius U, et al. Measurement of clinical and subclinical tumour response using [18F]fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group [J]. Eur J Cancer, 1999; 35(13): 17731782.
14.	Choi H, Charnsangavej C, Faria SC, et al. Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria [J]. J Clin Oncol, 2007; 25(13): 17531759.
15.	嚴超, 朱正綱, 燕敏, 等. 內鏡超聲檢查和多層螺旋CT對胃癌淋巴結轉移狀況的評估價值 [J]. 中華外科雜志, 2005; 43(3): 174176.
16.	嚴超, 朱正綱, 燕敏, 等. 多排CT 對早期胃癌術前評估的價值 [J]. 外科理論與實踐, 2008; 13(1): 3439.
17.	Allum WH, Griffin SM, Watson A, et al. Guidelines for the management of oesophageal and gastric cancer [J]. Gut, 2002; 50(Suppl 5): 123.
18.	Shimizu1 K, Ito K, Matsunaga N, et al. Diagnosis of gastric cancer with MDCT using the waterfilling method and multiplanar reconstruction: CThistologic correlation [J]. AJR Am J Roentgenol, 2005; 185(5): 11521158.
19.	Park SR, Lee JS, Kim CG, et al. Endoscopic ultrasound and computed tomography in restaging and predicting prognosis after neoadjuvant chemotherapy in patients with locally advanced gastric cancer [J]. Cancer, 2008; 112(11): 23682376.
20.	Di Fabio F, Pinto C, Rojas Llimpe FL, et al. The predictive value of 18FFDGPET early evaluation in patients with metastatic gastric adenocarcinoma treated with chemotherapy plus cetuximab [J]. Gastric Cancer, 2007; 10(4): 221227.
21.	Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma－2nd English edition: response assessment of chemotherapy and radiotherapy for gastric carcinoma: clinical criteria [J]. Gastric Cancer, 2001; 4(1): 18.
22.	Kurihara M, Aiko T. The new Japanese classification of gastric carcinoma: revised explanation of “response assessment of chemotherapy and radiotherapy for gastric carcinoma” [J]. Gastric Cancer, 2001; 4(1): 913.
23.	Benjamin RS, Choi H, Macapinlac HA, et al. We should desist using RECIST, at least in GIST [J]. J Clin Oncol, 2007; 25 (13): 17601764.
24.	Lee SM, Kim SH, Lee JM, et al. Usefulness of CT volumetry for primary gastric lesions in predicting pathologic response to neoadjuvant chemotherapy in advanced gastric cancer [J]. Abdom Imaging, 2009; 34(4): 430440.
25.	嚴超, 朱正綱, 燕敏，等. 內鏡超聲檢查對胃癌術前分期的價值 [J]. 中國內鏡雜志, 2003; 9(5): 3236.
26.	Mesenas S, Vu C, McStay M, et al. A large series, resection controlled study to assess the value of radial EUS in restaging gastroesophageal cancer following neoadjuvant chemotherapy [J]. Dis Esophagus, 2008; 21(1): 3742.
27.	Blackshaw G, Lewis WG, Hopper AN, et al. Prospective comparison of endosonography, computed tomography, and histopathological stage of junctional oesophagogastric cancer [J]. Clin Radiol, 2008; 63(10): 10921098.
28.	Motohara T, Semelka RC. MRI in staging of gastric cancer [J]. Abdom Imaging, 2002; 27(4): 376383.
29.	Kwee RM, Kwee TC. Imaging in local staging of gastric cancer: a systematic review [J]. J Clin Oncol, 2007; 25(15): 21072116.
30.	Arocena MG, Barturen A, Bujanda L, et al. MRI and endoscopic ultrasonography in the staging of gastric cancer [J]. Rev Esp Enferm Dig, 2006; 98(8): 582590.
31.	Roth Y, Tichler T, Kostenich G, et al. Highbvalue diffusionweighted MR imaging for pretreatment prediction and early monitoring of tumor response to therapy in mice [J]. Radiology, 2004; 232(3): 685692.
32.	Thoeny HC, De Keyzer F, Chen F, et al. Diffusionweighted MR imaging in monitoring the effect of a vascular targeting agent on rhabdomyosarcoma in rats [J]. Radiology, 2005; 234(3): 756764.
33.	Naganawa S, Sato C, Kumada H, et al. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix [J]. Eur Radiol, 2005; 15(1): 7178.
34.	Batchelor TT, Sorensen AG, di Tomaso E, et al. AZD2171, a panVEGF receptor tyrosine kinase inhibitor, normalizes tumor vasculature and alleviates edema in glioblastoma patients [J]. Cancer Cell, 2007; 11(1): 8395.
35.	Esteves FP, Schuster DM, Halkar RK. Gastrointestinal tract malignancies and positron emission tomography: an overview [J]. Semin Nucl Med, 2006; 36(2):169181.
36.	Dehdashti F, Siegel BA. Neoplasms of the esophagus and stomach [J]. Semin Nucl Med, 2004; 34(3): 198208.
37.	Yun M, Lim JS, Noh SH, et al. Lymph node staging of gastric cancer using 18FFDG PET: a comparison study with CT [J]. J Nucl Med, 2005; 46(10): 15821588.
38.	Kim SK, Kang KW, Lee JS, et al. Assessment of lymph node metastases using 18FFDG PET in patients with advanced gastric cancer [J]. Eur J Nucl Med Mol Imaging, 2006; 33(2): 148155.
39.	Chen J, Cheong JH, Yun MJ, et al. Improvement in preoperative staging of gastric adenocarcinoma with positron emission tomography [J].Cancer, 2005; 103(11): 23832390.
40.	Suttie SA, Welch AE, Park KG. Positron emission tomography for monitoring response to neoadjuvant therapy in patients with oesophageal and gastrooesophageal junction carcinoma [J]. Eur J Surg Oncol, 2009; 35(10): 10191029.
41.	Yun M, Choi HS, Yoo E, et al. The role of gastric distention in differentiating recurrent tumor from physiologic uptake in the remnant stomach on 18FFDG PET [J]. J Nucl Med, 2005; 46(6): 953957.
42.	Tian J, Chen L, Wei B, et al. The value of vesicant 18Ffluorodeoxyglucose positron emission tomography (18FFDG PET) in gastric malignancies [J]. Nucl Med Commun, 2004; 25(8): 825831.
43.	Imperiale A, Cimarelli S, Sellem DB, et al. Focal F18 FDG uptake mimicking malignant gastric localizations disappearing after water ingestion on PET/CT images [J]. Clin Nucl Med, 2006; 31(12): 835837.
44.	Zhu Z, Li F, Mao Y, et al. Improving evaluation of primary gastric malignancies by distending the stomach with milk immediately before 18FFDG PET scanning [J]. J Nucl Med Technol, 2008; 36(1): 2529.
45.	Zhu Z, Li F, Zhuang H. Gastric distension by ingesting food is useful in the evaluation of primary gastric cancer by FDG PET [J]. Clin Nucl Med, 2007; 32(2): 106109.
46.	Ott K, Lordick F, Herrmann K, et al. The new credo: induction chemotherapy in locally advanced gastric cancer: consequences for surgical strategies [J]. Gastric Cancer, 2008; 11(1): 19.
47.	季加孚. 胃癌外科的現狀與發展趨勢 [J]. 中國普外基礎與臨床雜志, 2006; 13(1): 13.

1. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer [J]. N Engl J Med, 2006; 355(1): 1120.
2. Boige V, Pignon J, SaintAubert B, et al. Final results of a randomized trial comparing preoperative 5fluorouracil (F)/cisplatin (P) to surgery alone in adenocarcinoma of stomach and lower esophagus (ASLE): FNLCC ACCORD07FFCD 9703 trial [J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4510.
3. 方育, 王亞軍, 李非, 等. 奧沙利鉑聯合甲酰四氫葉酸鈣和氟尿嘧啶新輔助化療方案治療進展期胃癌的研究 [J]. 中華胃腸外科雜志, 2006; 9(6): 510512.
4. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Gastric cancer (NCCN).v.2. 2009. http://www.nccn.org/professionals/physician_gls/PDF/gastric.pdf.
5. Ninomiya Y, Yanagisawa A, Kato Y, et al. Histological indications of a favorable prognosis with faradvanced gastric carcinomas after preoperative chemotherapy [J]. J Cancer Res Clin Oncol, 1999; 125(12): 699706.
6. Becker K, Mueller JD, Schulmacher C, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy [J]. Cancer, 2003; 98(7): 15211530.
7. Weber WA, Ott K, Becker K, et al. Prediction of response to preoperative chemotherapy in adenocarcinomas of the esophagogastric junction by metabolic imaging [J]. J Clin Oncol, 2001; 19(12): 30583065.
8. Ott K, Fink U, Becker K, et al. Prediction of response to preoperative chemotherapy in gastric carcinoma by metabolic imaging: results of a prospective trial [J]. J Clin Oncol, 2003; 21(24): 46044610.
9. Ott K, Weber WA, Lordick F, et al. Metabolic imaging predicts response, survival, and recurrence in adenocarcinomas of the esophagogastric junction [J]. J Clin Oncol, 2006; 24(29): 46924698.
10. Lordick F, Ott K, Krause BJ, et al. PET to assess early metabolic response and to guide treatment of adenocarcinoma of the oesophagogastric junction: the MUNICON phase Ⅱ trial [J]. Lancet Oncol, 2007; 8(9): 754755.
11. Miller AB, Hoogstraten B, Staquet M, et al. Reporting results of cancer treatment [J]. Cancer, 1981; 47(1): 207214.
12. Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors [J]. J Natl Cancer Inst, 2000; 92(3): 205216.
13. Young H, Baum R, Cremerius U, et al. Measurement of clinical and subclinical tumour response using [18F]fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group [J]. Eur J Cancer, 1999; 35(13): 17731782.
14. Choi H, Charnsangavej C, Faria SC, et al. Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria [J]. J Clin Oncol, 2007; 25(13): 17531759.
15. 嚴超, 朱正綱, 燕敏, 等. 內鏡超聲檢查和多層螺旋CT對胃癌淋巴結轉移狀況的評估價值 [J]. 中華外科雜志, 2005; 43(3): 174176.
16. 嚴超, 朱正綱, 燕敏, 等. 多排CT 對早期胃癌術前評估的價值 [J]. 外科理論與實踐, 2008; 13(1): 3439.
17. Allum WH, Griffin SM, Watson A, et al. Guidelines for the management of oesophageal and gastric cancer [J]. Gut, 2002; 50(Suppl 5): 123.
18. Shimizu1 K, Ito K, Matsunaga N, et al. Diagnosis of gastric cancer with MDCT using the waterfilling method and multiplanar reconstruction: CThistologic correlation [J]. AJR Am J Roentgenol, 2005; 185(5): 11521158.
19. Park SR, Lee JS, Kim CG, et al. Endoscopic ultrasound and computed tomography in restaging and predicting prognosis after neoadjuvant chemotherapy in patients with locally advanced gastric cancer [J]. Cancer, 2008; 112(11): 23682376.
20. Di Fabio F, Pinto C, Rojas Llimpe FL, et al. The predictive value of 18FFDGPET early evaluation in patients with metastatic gastric adenocarcinoma treated with chemotherapy plus cetuximab [J]. Gastric Cancer, 2007; 10(4): 221227.
21. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma－2nd English edition: response assessment of chemotherapy and radiotherapy for gastric carcinoma: clinical criteria [J]. Gastric Cancer, 2001; 4(1): 18.
22. Kurihara M, Aiko T. The new Japanese classification of gastric carcinoma: revised explanation of “response assessment of chemotherapy and radiotherapy for gastric carcinoma” [J]. Gastric Cancer, 2001; 4(1): 913.
23. Benjamin RS, Choi H, Macapinlac HA, et al. We should desist using RECIST, at least in GIST [J]. J Clin Oncol, 2007; 25 (13): 17601764.
24. Lee SM, Kim SH, Lee JM, et al. Usefulness of CT volumetry for primary gastric lesions in predicting pathologic response to neoadjuvant chemotherapy in advanced gastric cancer [J]. Abdom Imaging, 2009; 34(4): 430440.
25. 嚴超, 朱正綱, 燕敏，等. 內鏡超聲檢查對胃癌術前分期的價值 [J]. 中國內鏡雜志, 2003; 9(5): 3236.
26. Mesenas S, Vu C, McStay M, et al. A large series, resection controlled study to assess the value of radial EUS in restaging gastroesophageal cancer following neoadjuvant chemotherapy [J]. Dis Esophagus, 2008; 21(1): 3742.
27. Blackshaw G, Lewis WG, Hopper AN, et al. Prospective comparison of endosonography, computed tomography, and histopathological stage of junctional oesophagogastric cancer [J]. Clin Radiol, 2008; 63(10): 10921098.
28. Motohara T, Semelka RC. MRI in staging of gastric cancer [J]. Abdom Imaging, 2002; 27(4): 376383.
29. Kwee RM, Kwee TC. Imaging in local staging of gastric cancer: a systematic review [J]. J Clin Oncol, 2007; 25(15): 21072116.
30. Arocena MG, Barturen A, Bujanda L, et al. MRI and endoscopic ultrasonography in the staging of gastric cancer [J]. Rev Esp Enferm Dig, 2006; 98(8): 582590.
31. Roth Y, Tichler T, Kostenich G, et al. Highbvalue diffusionweighted MR imaging for pretreatment prediction and early monitoring of tumor response to therapy in mice [J]. Radiology, 2004; 232(3): 685692.
32. Thoeny HC, De Keyzer F, Chen F, et al. Diffusionweighted MR imaging in monitoring the effect of a vascular targeting agent on rhabdomyosarcoma in rats [J]. Radiology, 2005; 234(3): 756764.
33. Naganawa S, Sato C, Kumada H, et al. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix [J]. Eur Radiol, 2005; 15(1): 7178.
34. Batchelor TT, Sorensen AG, di Tomaso E, et al. AZD2171, a panVEGF receptor tyrosine kinase inhibitor, normalizes tumor vasculature and alleviates edema in glioblastoma patients [J]. Cancer Cell, 2007; 11(1): 8395.
35. Esteves FP, Schuster DM, Halkar RK. Gastrointestinal tract malignancies and positron emission tomography: an overview [J]. Semin Nucl Med, 2006; 36(2):169181.
36. Dehdashti F, Siegel BA. Neoplasms of the esophagus and stomach [J]. Semin Nucl Med, 2004; 34(3): 198208.
37. Yun M, Lim JS, Noh SH, et al. Lymph node staging of gastric cancer using 18FFDG PET: a comparison study with CT [J]. J Nucl Med, 2005; 46(10): 15821588.
38. Kim SK, Kang KW, Lee JS, et al. Assessment of lymph node metastases using 18FFDG PET in patients with advanced gastric cancer [J]. Eur J Nucl Med Mol Imaging, 2006; 33(2): 148155.
39. Chen J, Cheong JH, Yun MJ, et al. Improvement in preoperative staging of gastric adenocarcinoma with positron emission tomography [J].Cancer, 2005; 103(11): 23832390.
40. Suttie SA, Welch AE, Park KG. Positron emission tomography for monitoring response to neoadjuvant therapy in patients with oesophageal and gastrooesophageal junction carcinoma [J]. Eur J Surg Oncol, 2009; 35(10): 10191029.
41. Yun M, Choi HS, Yoo E, et al. The role of gastric distention in differentiating recurrent tumor from physiologic uptake in the remnant stomach on 18FFDG PET [J]. J Nucl Med, 2005; 46(6): 953957.
42. Tian J, Chen L, Wei B, et al. The value of vesicant 18Ffluorodeoxyglucose positron emission tomography (18FFDG PET) in gastric malignancies [J]. Nucl Med Commun, 2004; 25(8): 825831.
43. Imperiale A, Cimarelli S, Sellem DB, et al. Focal F18 FDG uptake mimicking malignant gastric localizations disappearing after water ingestion on PET/CT images [J]. Clin Nucl Med, 2006; 31(12): 835837.
44. Zhu Z, Li F, Mao Y, et al. Improving evaluation of primary gastric malignancies by distending the stomach with milk immediately before 18FFDG PET scanning [J]. J Nucl Med Technol, 2008; 36(1): 2529.
45. Zhu Z, Li F, Zhuang H. Gastric distension by ingesting food is useful in the evaluation of primary gastric cancer by FDG PET [J]. Clin Nucl Med, 2007; 32(2): 106109.
46. Ott K, Lordick F, Herrmann K, et al. The new credo: induction chemotherapy in locally advanced gastric cancer: consequences for surgical strategies [J]. Gastric Cancer, 2008; 11(1): 19.
47. 季加孚. 胃癌外科的現狀與發展趨勢 [J]. 中國普外基礎與臨床雜志, 2006; 13(1): 13.

《中國普外基礎與臨床雜志》

胃癌新輔助化療療效臨床評價方法及進展

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《中國普外基礎與臨床雜志》

胃癌新輔助化療療效臨床評價方法及進展

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料