Predoperativna radiokemoterapija pri bolnikih z neresektabilnim karcinomom želodca Preoperative radiochemotherapy for patients with unresectable stomach carcinoma

Povzetek

Osnovno zdravljenje karcinoma želodca je radikalna resekcija. Ob postavitvi diagnoze je bolezen neresktabilna pri približno 50 % bolnikov. Znano je, da predoperativna radiokemoterapija lahko zmanjša tumor, kar povečuje možnost radikalne resekcije in podaljša preživetje teh bolnikov. V Sloveniji smo pri bolnikih z neresektabilnim nemetastatskim karcinomom želodca predoperativno radiokemoterapijo uvedli leta 2006. Uporabljamo 3-dimenzionalno konformalno načrtovanje obsevanja z računalniško tomografijo ter sočasno kemoterapijo s 5-FU in cisplatinom. Do sedaj je omenjeno zdravljenje prejelo 36 bolnikov. 19 bolnikov je bilo operiranih. Pri 12 (63 %) je bila bolezen odstranjena v celoti, pri 3 (16 %) je bil prisoten mikroskopski ostanek (R1 resekcija), pri 4 (21 %) pa je bil opravljen le paliativni poseg. Podrobnejša analiza bo opravljena po zdravljenju večjega števila bolnikov.

Abstract (Eng)

Radical resection is the basic treatment for stomach carcinoma. At the time of diagnosis, the disease is unresectable in nearly 50% of patients. It is known that preoperative radiochemotherapy can downstage the tumor and thereby allowing higher probability of radical resection and improving survival of patients. In 2006 preoperative radiochemotherapy was started in Slovenia for patients with non-metastatic unresectable stomach tumors. Three-dimensional conformal treatment planning with computer tomography and concomitant chemotherapy with 5-FU and cisplatin were used. So far, 36 patients received the above-mentioned treatment. In nineteen patients who were operated on so far, radical resection was performed in 12 (63%). In 3 (16%) patients microscopic residual disease (R1 resection) was found, and in 4 (21%) patients, only paliative surgery was performed. A detailed analysis of treatment success will be performed after obtaining the treatment results of greater number of treated patients.