How to treat advanced gastric cancer
summary
My grandfather has been hospitalized for advanced gastric cancer during this period of time. The development of his condition is relatively serious. The doctor suggested us to treat it conservatively. He said that the old man is too old to be operated on. Let me introduce how to treat advanced gastric cancer.
How to treat advanced gastric cancer
Radical resection: there are two kinds of radical resection: radical resection and extended radical resection. (1) The scope of radical resection should include the primary lesion, 2 / 3 or 4 / 5 of the distal part of the stomach, all omentum and omentum, the first part of duodenum and regional lymph nodes, as well as locally infiltrated organs. There is no residual cancer at the end of the stomach or duodenum. (2) In addition to the above, the whole stomach or adjacent invaded transverse colon, left lobe of liver, spleen, body and tail of pancreas and lymph nodes beside the left and splenic vessels of cardia should be resected.
The second method: radiotherapy, radiation complications, and even cause partial loss of function; for patients with advanced cancer, radiotherapy effect is not good. At the same time, for patients with poor constitution and older age, continued radiotherapy can only lead to more vulnerable life and accelerate the death of patients. The radiosensitivity of gastric adenocarcinoma is low. After radiotherapy alone or combined with chemotherapy, only 60% of the tumors shrink by more than 50%, and only 10% of the tumors disappear completely. Therefore, radiotherapy alone can not be used to cure gastric cancer. The role of radiotherapy in the treatment of gastric cancer is mainly adjuvant or palliative.
The third method: chemotherapy. There are many chemotherapy schemes for gastric cancer. The following schemes are provided for reference only: (1) taxol 210 mg / m2 i.v. (3-hour infusion) (2) ECF epirubicin 50 mg / m2 i.v. (3-hour infusion) D1 * cisplatin 60 mg / m2 i.v. D1 * 5-FU 200 mg / m2 / D (continuous infusion) 21 days * repeated every 21 days. (3) famtx methotrexate 1000-1500 mg / m2 i.v. D1, 5-FU 1500 mg / m2 i.v. D1 after 1 hour Doxorubicin 30mg / m2 i.v. D15 folic acid 15mg / m2 P.O. was given every 6 hours for 12 times, starting 24 hours after methotrexate administration. After 4 weeks, (4) elf etoposide 20mg / m2 i.v. (50 min infusion) D1-3 tetrahydrofolate 300mg / m2 i.v. (10 min infusion) D1-3 5-FU 500mg / m2 i.v. (10 min infusion) D1-3 every 3-4 weeks, (5) taxol + 5-FU + DDP taxol 175mg / m2 i.v. (3H) d1-5-fu 750mg / M2 i.v. (24h continuous infusion) D1-5 DDP 20mg / m2 i.v. (2H) D1-5 every 4 weeks.
matters needing attention
Patients with advanced gastric cancer should eat reasonably to prevent the occurrence of the above complications: 1) eat less and eat more, patients with subtotal gastrectomy should eat less and eat more, 6-7 times a day, regular and quantitative meals can make the stomach not empty, but also gradually adapt to the digestive function of the remnant stomach. Less food and more meals should be an important dietary system for patients with gastric cancer after resection. 2) In order to prolong the stay time of food in the stomach, we can only eat dry food without drinking water. We can drink water 30 minutes after the meal, so as to avoid the food being washed into the small intestine quickly, pass through the small intestine slowly, and promote the further absorption of food. 3) Limit carbohydrate intake and prevent dumping syndrome.
