多模式精准治疗时代癌症腹膜转移的新兴治疗模式
Emerging treatment paradigms for gastric cancer peritoneal metastasis in the era of multimodal precision therapy.
摘要(中文译文)
胃癌腹膜转移（GCPM）通常在疾病已进展至进展期或晚期时才被诊断，且预后明显较差。由于早期检测困难，且传统全身治疗的获益仍然有限，GCPM长期以来在常规临床实践中被视为一种难以治疗的亚型。近年来，分子分型的进展推动了个体化多模式治疗策略的探索，免疫检查点抑制剂、分子靶向药物和细胞治疗等全身性方法越来越多地被纳入晚期胃癌和GCPM的治疗。与此同时，包括腹腔热灌注化疗和新辅助腹腔联合全身化疗在内的区域腹腔治疗模式，已在部分选定患者中显示出潜在获益。在此基础上，本综述综合了来自主要指南、专家共识声明和标志性临床试验的最新证据，对GCPM全身治疗和区域治疗的关键进展进行了结构化概述，分析了获益患者的特征及当前方法的固有局限性，并讨论了实现全身治疗与区域治疗协同以延长生存和改善临床结局的未来方向。
Abstract
Gastric cancer peritoneal metastasis (GCPM) is usually diagnosed when the disease has already reached a progressive or advanced stage and is associated with a distinctly poor prognosis. Because early detection is difficult and the benefit of conventional systemic therapy remains limited, GCPM has long been regarded as a difficult-to-treat subtype in routine clinical practice. In recent years, advances in molecular classification have driven the exploration of individualised multimodal treatment strategies, with systemic approaches such as immune checkpoint inhibitors, molecularly targeted agents and cellular therapies increasingly incorporated into the management of advanced gastric cancer and GCPM. In parallel, regional intraperitoneal modalities, including hyperthermic intraperitoneal chemotherapy and neoadjuvant intraperitoneal plus systemic chemotherapy, have demonstrated potential benefit in selected patients. On this basis, the present review synthesises up-to-date evidence from major guidelines, expert consensus statements and landmark clinical trials, provides a structured overview of key advances in systemic and regional treatment for GCPM, examines the characteristics of patients who derive benefit and the inherent limitations of current approaches, and discusses future directions for achieving synergy between systemic and regional therapies to prolong survival and improve clinical outcomes.
如何引用
AMA
Qiuli Wang, Shulin Wang, Jingyu Yao, Yangjun Gao, Wenxia Wang, Jun Zhao. Emerging treatment paradigms for gastric cancer peritoneal metastasis in the era of multimodal precision therapy.. Critical reviews in oncology/hematology. 2026; doi:10.1016/j.critrevonc.2026.105347.
APA
Qiuli Wang, Shulin Wang, Jingyu Yao, Yangjun Gao, Wenxia Wang, Jun Zhao (2026). Emerging treatment paradigms for gastric cancer peritoneal metastasis in the era of multimodal precision therapy.. Critical reviews in oncology/hematology. https://doi.org/10.1016/j.critrevonc.2026.105347
GB/T 7714
Qiuli Wang, Shulin Wang, Jingyu Yao, Yangjun Gao, Wenxia Wang, Jun Zhao. Emerging treatment paradigms for gastric cancer peritoneal metastasis in the era of multimodal precision therapy.[J]. Critical reviews in oncology/hematology, 2026 doi:10.1016/j.critrevonc.2026.105347.
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