D2 Rezeksiyonlu Mide Kanserlerinde Adjuvan Kemoradyoterapi

Yıl 2019, Cilt: 1 Sayı: 3, 108 - 114, 31.12.2019

Ahmet Küçük , Erkan Topkan

Öz

Lokal ileri evre mide kanserli hastalarda multidisipliner
tedavi yaklaşımı etkin hastalık kontrolü ve yüksek yaşam kalitesi bakımlarından
oldukça önemlidir. Radyoterapi (RT) ile birlikte birçok kemoterapotik ajan
preoperatif veya postoperatif dönemlerde uygulanabilse de en doğru zamanlama,
rejim ve dozlar halen tartışmalıdır. Southwest Oncology Group/Inter group 116 (SWOG/INT
116) çalışması adjuvan kemoradyoterapinin (KRT) lokal ileri evre mide kanserinin
multidisipliner tedavi yaklaşımındaki rolünü belirleyen temel çalışma olarak
kabul görmektedir. Ancak adjuvan KRT’nin D2 lenfatik diseksiyon uygulanmış R0
gastrektomili hastalardaki gerekliliği belirsizliğini korusa da mevcut prospektif
randomize çalışma ve metaanaliz sonuçları postoperatif KRT’nin lokal bölgesel
nüksü azalttığı ve buna bağlı olarak hastalıksız sağ kalımı uzattığını
göstermektedir. Ancak tedavi kararı alınırken tümör evresi, nodal tutulum
durumu ve histopatolojik özellikler gibi prognostik faktörlerin cerrahi sonrası
KRT alması gereken alt grupların belirlenmesinde etken olduğu ve dolayısıyla
kişiye özgü tedavilerin gerekliliği unutulmamalıdır. Eldeki verilerin görece
sınırlı olması postoperatif KRT’den fayda görebilecek hastaların doğru olarak
belirlenebilmesi için büyük ölçekli prospektif randomize çalışmalara olan ihtiyacı
vurgulamaktadır.

Anahtar Kelimeler

Mide kanseri, adjuvan tedavi, kemoterapi, radyoterapi

Kaynakça

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