Classification of gastric cancer chemotherapy drugs, according to the different ways chemotherapy can be divided into systemic chemotherapy and chemotherapy, local chemotherapy:
1. Systemic chemotherapy is the most common means of chemotherapy, mainly intravenous chemotherapy. Intravenous chemotherapy is divided into peripheral and central intravenous chemotherapy, intravenous chemotherapy. Because the use of intravenous Xueguan differences in the concentrations of chemotherapy drugs, drug delivery rate of drugs on the local vascular damage and so on are different, in particular, there are many points in the care, see the relevant chapters later.
2. Local chemotherapy is the most widely used arterial infusion chemotherapy. Such as liver metastasis of primary liver cancer and some other commonly used method of arterial infusion chemotherapy, the aim of using local tumor blood supply and to give local lesions larger dose of chemotherapy drugs can improve efficacy, while reducing high dose chemotherapy Drug-induced systemic toxicity. Intracavitary chemotherapy is also a local chemotherapy, commonly used chemotherapy, including chest cavity, abdominal cavity, the pericardial cavity and the spinal cord cavity chemotherapy. Intracavitary chemotherapy on the indications and considerations detailed in subsequent chapters.
Depending on the number and type of chemotherapy is different from chemotherapy can be divided into single-agent chemotherapy, combination chemotherapy and bio-chemotherapy.
1. Single-agent chemotherapy, the following situations can be applied to single-agent chemotherapy. Some cancer chemotherapy, but remission is short, stop tumor recurrence after chemotherapy, chemotherapy given to patients on intermittent single-agent chemotherapy may prolong remission time, create opportunities for the re-treatment. If we apply the test etoposide (etoposide, VP-16) for lymphomas maintenance therapy after induction chemotherapy, has been made in better effect. In addition, some tumors are chemotherapy-sensitive tumors, or because of patient age, or because for some reason the patient can not tolerate the standard dose chemotherapy, when given the main purpose of single-agent chemotherapy is to control symptoms, improve quality of life, to gain time for further treatment. There is also a new drug in clinical trials, see the specific content of the relevant sections of the future.
2. MDT is based on principles of cell proliferation kinetics, select two or more different mechanism of action, toxicity different cycle specific and cycle non-specific combination of chemotherapy drugs. Chemotherapy drugs used in chemotherapy, the number of generally 3_4 were the best.
First with the cycle of non-specific drugs, a lot of killing tumor cells, the reduction in the total number of tumor cells, so that more tumor cells into the cell cycle, which were then applied to kill the cell cycle specific drugs. In addition, the first with a cell cycle specific drugs to block tumor cells in a given cycle, the drug disappeared, the tumor cells that is synchronized to the next cycle, the role of time and then this cycle of drugs, may be more to kill tumor cells and less damage normal cells. However, only a small portion of solid tumors, tumor cell proliferation cycle is difficult to synchronize all tumor cells into the same cycle. The commonly used chemotherapy regimens, mostly high-dose intermittent administration.
3. Biochemistry therapy (biochemotherapy) bio-chemotherapy of malignant tumors is different from cancer patients for the specific circumstances of a planned, rational application of biological response modifiers and chemotherapy drugs, in order to achieve improved cancer cure rates and improved survival of cancer patients purposes. Biological response modifiers for a variety of malignant tumors have a direct or indirect anti-tumor activity in combination with chemotherapy drugs or the effect of additive synergistic effect.
Current application of the better bio-chemotherapy tumor malignant melanoma, renal cell carcinoma and so on. U.S. M. D. Anderson Cancer Center reported many times in recent years, application of cisplatin, vinblastine, nitrogen en Mi amine in combination with interferon, interleukin -2 treatment of advanced malignant melanoma, the total efficiency of 50%, 10% long-term disease-free survival of patients. The author also reported interferon, interleukin-of combination chemotherapy of malignant melanoma, compared with chemotherapy can improve survival. In addition, chemotherapy, gene therapy, such as Her-ceptin (no Chinese translation) combined with paclitaxel in the treatment of advanced breast cancer; U.S. Rockwell (Rituximab) combined with chemotherapy in the treatment of malignant lymphoma have received a better effect. Chemotherapy for gastric cancer is still exploring the biological. Japan, South Korea's data suggest that lentinan, OK-432 and other consolidation therapy after surgery for gastric cancer patients and terminally ill patients in palliative care, disease-free survival time and median survival time than chemotherapy alone. I have reported the lentinan treatment including chemotherapy, including 99 cases of advanced gastric cancer patients with advanced cancer, and chemotherapy in the control group, the results of symptom improvement, objective response, survival and immune function (TI, T4, TI/T4 ) and other benefits are obvious.
4. Chemotherapy Classification of chemotherapy and other treatments based on the relationship, but also into adjuvant chemotherapy and the chemotherapy, neoadjuvant chemotherapy.
(1) adjuvant chemotherapy: is defined as an effective local treatment (surgery or radiotherapy), the primary local treatment for micrometastases may exist, in order to prevent recurrence or metastasis by chemotherapy. For example, the blood tumor on postoperative adjuvant chemotherapy can significantly improve the efficacy and help to save the limb. Another example of the high-risk breast cancer patients (lymph node metastasis, pre-menopausal, hormone receptor-negative, etc.), radical postoperative adjuvant chemotherapy can improve disease-free survival and overall survival. Adjuvant chemotherapy can be based on whether a radical surgical treatment is further divided into indicators of consolidation chemotherapy and no chemotherapy. All tumors in the specification were removed after surgery, postoperative immunohistochemical examination were related to negative real as adjuvant chemotherapy after radical consolidation chemotherapy; in pathological examinations showed no net margin, or the tumor markers continue to positive, but imaging studies (such as X ray, CT, MRI, B ultrasound or angiography) were negative in the non-real patients adjuvant chemotherapy after radical, often referred to as "non-target chemotherapy." Currently, breast cancer, colorectal cancer and osteosarcoma has been standard chemotherapy, and gastric cancer adjuvant chemotherapy and standard chemotherapy has yet to be more clinical studies to clear.
Classification of gastric cancer chemotherapy, (2) neoadjuvant chemotherapy: is defined as surgery or radiotherapy before and after the chemotherapy. Neoadjuvant chemotherapy has three purposes: First, the limitations of earlier clinical stage of tumor, chemotherapy before surgery first, because tumor shrinkage after chemotherapy, surgical resection can be reduced to reduce the damage caused by surgery (including amputation, etc.) and beauty, etc., significantly improve the patient's quality of life; for late clinical stage, but who have the possibility of surgical resection, preoperative chemotherapy can reduce the clinical stage and improve the resection rate. Secondly, neoadjuvant chemotherapy can be cleared or suppressed before and after operation of micrometastasis may exist to improve the prognosis. In addition, preoperative chemotherapy can be used as chemotherapy drug sensitivity test, refer to the efficacy of neoadjuvant chemotherapy, adjuvant chemotherapy can guide sm
ooth. Current neoadjuvant chemotherapy in gastric cancer has accumulated some aspects of the experience.