title: Systemic treatment of gastric cancer.
abstract: Gastric cancer is one of the commonest cancers worldwide and is associated with a poor prognosis. Surgery remains the only potentially curative treatment, but is associated with a high rate of locoregional recurrence. Hence, there is ongoing debate regarding both the extent of lymph node dissection and the role of perioperative chemotherapy or chemoradiation for localized disease. Untreated metastatic gastric cancer is associated with a median survival of only 3-4 months, but this can be increased to 8-10 months, associated with improved quality of life, with combination chemotherapy. Currently, no standard combination chemotherapy regimen exists, although regimens utilizing both cisplatin and 5-fluorouracil, such as epirubicin/cisplatin/fluorouracil (ECF), are amongst the most active. Newer chemotherapeutic agents, including irinotecan, oxaliplatin and taxanes, show promising activity, and are currently being tested in phase III trials.
authors.affiliation: Gastrointestinal Unit, Department of Medicine, Royal Marsden Hospital NHS Trust, London and Surrey, UK.
authors.forename: James L B
authors.initials: JL
authors.lastname: Dickson
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy / Q000379:methods; D015251:Epirubicin / Q000627:therapeutic use; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D009362:Neoplasm Metastasis; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D015251:Epirubicin; D002945:Cisplatin; D005472:Fluorouracil