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胃癌的治疗(PDQ®)

胃癌的基本信息

胃癌是在胃粘膜形成恶性肿瘤（癌）细胞的一种疾病。

胃是位于人体上腹部的一种J型器官。它是消化系统的一部分。消化系统主要处理人体所摄入食物中的营养成分（维生素、矿物质、碳水化合物、脂肪、蛋白质和水），并帮助将废弃物排出体外。食物要从咽喉部进入胃中，中间需经过一段由肌肉构成的空心管道，称为食道。经过部分消化的食物在离开胃后，进入小肠，然后再进入大肠。

食管和胃是上消化道（消化）系统的一部分。

胃壁由5层组织组成。从最内层到最外层，依次为：黏膜层、黏膜下层、肌层、浆膜下层（结缔组织）和浆膜层。胃癌起源于黏膜层，随着生长逐渐向外面的各层蔓延。

胃间质瘤起源于胃壁支持结缔组织，治疗方法与胃癌不同。欲了解更多信息，请见PDQ总结中有关胃肠道间质瘤治疗（成人）的内容。

如需更多关于胃癌的信息，请阅读以下PDQ总结。

  • 关于儿童罕见癌症的治疗方法
  • 胃癌预防
  • 胃癌筛查

    • 年龄、饮食习惯以及胃部疾病能够影响患胃癌的风险

    任何增加患病几率的因素叫做风险因素。有风险因素并不意味着你会得癌症，而没有风险因素也并不代表你不会得癌症。如果感觉有这样的风险，那就及早和医生咨询。胃癌的风险因素主要包括以下方面：

  • 有以下任何一种疾病征兆：
  • 胃内幽门螺杆菌感染。
  • 慢性胃炎（胃部炎症）。
  • 恶性贫血。
  • 肠上皮化生（正常的胃粘膜细胞被小肠上皮细胞所替代的一种疾病）。
  • 胃息肉。
  • EB（Epstein-Barr）病毒
  • 家族性综合征（包括家族性腺瘤性息肉病）。
  • 吃高盐食物，熏制食物以及水果蔬菜食用较少的饮食习惯。
  • 进食没有正确烹饪或贮存的食物。
  • 高龄或男性。
  • 吸烟。
  • 有父母或兄弟姐妹患胃癌。

    • 胃癌的病症包括消化不良、胃部疼痛不适。

    这些体征和其他症状可能由胃癌或其他疾病引起。

    在胃癌早期，可能出现以下一些症状：

  • 消化不良以及胃部不适
  • 进食后有腹胀感。
  • 轻度恶心。
  • 食欲不振。
  • 烧心感。

    • 胃癌中晚期可能发生以下一些症状：

  • 便血
  • 呕吐
  • 不明原因的体重减轻
  • 胃疼
  • 黄疸（眼睛和皮肤发黄）
  • 腹水（腹腔积液）
  • 吞咽困难

    • 如果有上述这些问题，请向医生咨询。

    通过对胃和食管的检查来发现和诊断胃癌。

    可能需要使用以下的一些检查以及程序：

  • 体格检查以及病史询问：进行体格检查来诊断身体的健康状况：包括检查一些疾病的症状，比如肿块以及其他一些不正常的状况。还将采集病人的卫生习惯、既往病史以及治疗史。
  • 血液生化检查：通过检查血液样本来测量体内器官和组织释放到血液中的某些物质的量。某种物质的含量异常（高于或低于正常范围）可能是疾病的征兆。
  • 全血细胞计数（CBC）：采集血样，然后进行以下的检测：
  • 红细胞、白细胞和血小板计数。
  • 红细胞中血红蛋白（携带氧气的蛋白质）的含量。
  • 血样中红细胞的组分。
  • 上消化道内镜检查：通过内镜检查食管、胃和十二指肠（小肠的第一部分），来检查不正常的区域。使用内窥镜（一根发光的细管）通过口腔穿过咽喉进入食管。
    • 上消化道内镜检查。通过口腔将一根细而发光的管子插入食管、胃和小肠第一部分，检查异常区域。
  • 钡餐：对食管和胃做一系列的X光检验。病人饮用一种含钡的液体（一种银白色的金属混合物）。这种液体覆盖在食管和胃上，然后进行X光检验。这一程序也被称作上消化道GI检验。
    • 胃癌的钡餐检查方法。患者吞下钡液，钡液通过食管进入胃。使用X光来寻找异常区域。
  • CT扫描（CAT扫描）：从不同角度拍摄身体内部区域（如胸部、腹部和骨盆）的一系列详细图像。这些图像通过连接在X线机上的电脑生成。可能需要向血管中注射一种显影剂或者吞咽一种显影剂，以便器官和组织显示得更清晰。这一程序也被称作计算机断层扫描，或计算机断层摄影术或计算机轴向断层扫描。
  • 活检：获取一些细胞或组织，在显微镜下对它们进行检查，寻找癌症的证据。胃部活检通常在内镜检查过程中完成。

    • 可以通过检查组织样本来测量HER2基因以及HER2蛋白的量。如果HER2基因或HER2蛋白高于正常水平，这种癌症被称为HER2阳性。HER2阳性的胃癌可使用一种以HER2蛋白为靶点的单克隆抗体进行治疗。

    还可以通过组织标本检查是否有幽门螺杆菌（H. pylori）感染。

    影响预后（康复机会）以及治疗方案的因素。

    预后（康复机会）以及治疗方案主要取决于以下方面：

  • 癌症分期（癌细胞是否只在胃部还是已经扩散到淋巴结或身体的其他部分）。
  • 病人的一般健康状况。

    • 胃癌如果能被及早地发现，那么康复机会就会较大。通常胃癌在诊断时已经发展到了中期以上。如果已经发展到了晚期，胃癌虽然仍可以治疗，但已经很难被治愈了。可以考虑参加一些改善治疗的临床试验。有关临床试验的信息可参见NCI网站的临床试验部分。

    Gastric Cancer Treatment (PDQ®)

    General Information About Gastric Cancer

    Gastric cancer is a disease in which malignant (cancer) cells form in the lining of the stomach.

    The stomach is a J-shaped organ in the upper abdomen. It is part of the digestive system, which processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) in foods that are eaten and helps pass waste material out of the body. Food moves from the throat to the stomach through a hollow, muscular tube called the esophagus. After leaving the stomach, partly-digested food passes into the small intestine and then into the large intestine.

    The esophagus and stomach are part of the upper gastrointestinal (digestive) system.

    The wall of the stomach is made up of 5 layers of tissue. From the innermost layer to the outermost layer, the layers of the stomach wall are: mucosa, submucosa, muscle, subserosa (connective tissue), and serosa. Gastric cancer begins in the mucosa and spreads through the outer layers as it grows.

    Stromal tumors of the stomach begin in supporting connective tissue and are treated differently from gastric cancer. See the PDQ summary on Gastrointestinal Stromal Tumors Treatment (Adult) for more information.

    For more information about cancers of the stomach, see the following PDQ summaries:

  • Unusual Cancers of Childhood Treatment
  • Stomach (Gastric) Cancer Prevention
  • Stomach (Gastric) Cancer Screening

    • Age, diet, and stomach disease can affect the risk of developing gastric cancer.

    Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for gastric cancer include the following:

  • Having any of the following medical conditions:
  • Helicobacter pylori (H. pylori) infection of the stomach.
  • Chronic gastritis (inflammation of the stomach).
  • Pernicious anemia.
  • Intestinal metaplasia (a condition in which the normal stomach lining is replaced with the cells that line the intestines).
  • Gastric polyps.
  • Epstein-Barr virus.
  • Familial syndromes (including familial adenomatous polyposis).
  • Eating a diet high in salted, smoked foods and low in fruits and vegetables.
  • Eating foods that have not been prepared or stored properly.
  • Being older or male.
  • Smoking cigarettes.
  • Having a mother, father, sister, or brother who has had stomach cancer.

    • Symptoms of gastric cancer include indigestion and stomach discomfort or pain.

    These and other signs and symptoms may be caused by gastric cancer or by other conditions.

    In the early stages of gastric cancer, the following symptoms may occur:

  • Indigestion and stomach discomfort.
  • A bloated feeling after eating.
  • Mild nausea.
  • Loss of appetite.
  • Heartburn.

    • In more advanced stages of gastric cancer, the following signs and symptoms may occur:

  • Blood in the stool.
  • Vomiting.
  • Weight loss for no known reason.
  • Stomach pain.
  • Jaundice (yellowing of eyes and skin).
  • Ascites (build-up of fluid in the abdomen).
  • Trouble swallowing.

    • Check with your doctor if you have any of these problems.

    Tests that examine the stomach and esophagus are used to detect (find) and diagnose gastric cancer.

    The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
  • The number of red blood cells, white blood cells, and platelets.
  • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
  • The portion of the sample made up of red blood cells.
  • Upper endoscopy: A procedure to look inside the esophagus, stomach, and duodenum (first part of the small intestine) to check for abnormal areas. An endoscope (a thin, lighted tube) is passed through the mouth and down the throat into the esophagus.
    • Upper endoscopy. A thin, lighted tube is inserted through the mouth to look for abnormal areas in the esophagus, stomach, and first part of the small intestine.
  • Barium swallow: A series of x-rays of the esophagus and stomach. The patient drinks a liquid that contains barium (a silver-white metallic compound). The liquid coats the esophagus and stomach, and x-rays are taken. This procedure is also called an upper GI series.
    • Barium swallow for stomach cancer. The patient swallows barium liquid and it flows through the esophagus and into the stomach. X-rays are taken to look for abnormal areas.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. A biopsy of the stomach is usually done during the endoscopy.

    • The sample of tissue may be checked to measure how many HER2 genes there are and how much HER2 protein is being made. If there are more HER2 genes or higher levels of HER2 protein than normal, the cancer is called HER2 positive. HER2-positive gastric cancer may be treated with a monoclonal antibody that targets the HER2 protein.

    The sample of tissue may also be checked for Helicobacter pylori (H. pylori) infection.

    Certain factors affect prognosis (chance of recovery) and treatment options.

    The prognosis (chance of recovery) and treatment options depend on the following:

  • The stage of the cancer (whether it is in the stomach only or has spread to lymph nodes or other places in the body).
  • The patient’s general health.

    • When gastric cancer is found very early, there is a better chance of recovery. Gastric cancer is often in an advanced stage when it is diagnosed. At later stages, gastric cancer can be treated but rarely can be cured. Taking part in one of the clinical trials being done to improve treatment should be considered. Information about ongoing clinical trials is available from the NCI website.

    胃癌的治疗(PDQ®)

    胃癌分期

    胃癌一旦确诊，就需要进行一些检查，来判断癌细胞是只存在于胃部，还是已经扩散到身体的其他部位。

    通过检查来判断癌细胞是只存在于胃部，还是已经扩散到身体的其他部位，这一程序称为癌症分期。通过分期过程中所收集的信息来确定疾病所处的阶段。癌症分期对治疗计划的制定非常重要。

    分期过程中可能需要进行以下的检查以及程序。

  • EUS（超声内镜）： 一种通常通过口腔或直肠将内窥镜插入体内的检查方法。内窥镜是一种细的管状仪器，带有灯光及可视的透镜。内窥镜末端的探头可以向人体内部组织或器官发出高能量声波（超声波）并形成回声。这些回声形成人体组织的图像，称为超声图。这一过程也称为超声内镜检查。
  • CT扫描（CAT扫描）：从不同角度拍摄身体内部区域（如胸部、腹部和骨盆）的一系列详细图像。这些图像通过连接在X线机上的电脑生成。可能需要向血管中注射一种显影剂或者吞咽一种显影剂，以便器官和组织显示得更清晰。这一程序也被称作计算机断层扫描，或计算机断层摄影术或计算机轴向断层扫描。
  • PET扫描（正电子发射断层扫描）：一种在身体内查找恶性肿瘤细胞检查方法。将少量带放射性的葡萄糖注射到血管中。PET 扫描仪在身体周围环绕旋转并拍摄图像，了解这些葡萄糖在身体的什么部位被使用。恶性肿瘤细胞因为更具有活跃性并且比一般正常细胞吸收更多的葡萄糖，所以在图片中往往显得更明亮。PET扫描和CT扫描可以同时进行，这被称作做PET-CT检查.
  • MRI（磁共振成像）:一种使用磁体、无线电波和计算机生成一系列人体内部详细图像的检查方法。一种称作钆的物质被注入静脉。钆可以在癌细胞周围聚集，因此癌细胞在图像中显得更亮。这种检查也被称为核磁共振成像(NMRI)。
  • 腹腔镜检查：一种检查腹腔内部器官并寻找疾病迹象的外科手术程序。在腹腔壁上开几个小的切口，从一个切口插入腹腔镜（一种细而发光的管子）。其他仪器可通过同一个切口或其他切口插入，完成一定的操作，例如切除器官或提取组织样本，然后放到显微镜下检查癌症的迹象。可以使用一种液体冲洗腹腔器官的表面，然后吸出该液体，收集细胞。也可以在显微镜下观察这些细胞，检查癌症的迹象。

    • 癌细胞在体内有三种扩散方式。

    癌细胞可以通过组织、淋巴系统以及血液进行扩散。

  • 组织。癌细胞从始发部位逐渐生长扩散到附近的区域。
  • 淋巴系统。癌细胞从始发部位进入淋巴系统，并通过淋巴管扩散到身体的其他部位。
  • 血液。癌细胞从始发部位进入血液，并通过血管扩散到身体的其他部位。

    • 癌细胞能够从始发部位扩散到身体的其他部位。

    当癌细胞扩散到身体的其他部位，那被称作转移癌。癌细胞脱离最初发生的部位（原发肿瘤），通过淋巴系统或血液进行传播。

  • 淋巴系统。癌细胞进入淋巴系统，通过淋巴管道传播到身体的其他部位，并在该部位形成一个肿瘤（转移瘤）。
  • 血液。癌细胞进入血液，通过血管传播到身体的其他部位，并在该部位形成一个肿瘤（转移瘤）。

    • 转移瘤和原发肿瘤属于同一种类型的肿瘤。例如，如果胃癌转移到肝脏，那么肝脏中的癌细胞其实是胃癌细胞。这种病是转移性胃癌，而并不是肝癌。

    许多癌症死亡的原因是由于癌细胞从原发肿瘤转移到了其他组织和器官。这被称为转移癌。这个动画展示了癌细胞是如何从体内最初形成的部位扩散到其他部位的。

    胃癌分期如下：

    0期（原位癌）

    在0期，在胃壁粘膜层（最内层）发现异常细胞。这些异常细胞可能变成癌细胞，并扩散到附近的正常组织。0期又称为原位癌。

    胃壁的分层。胃壁由黏膜层（最内层）、黏膜下层、肌层、浆膜下层和浆膜层（最外层）组成。胃是上腹部的一个器官。

    Ⅰ期

    Ⅰ期分为ⅠA期和ⅠB期。

  • ⅠA期：已在胃壁的黏膜层（最内层）形成癌细胞，并且可能已扩散到黏膜下层（与黏膜层相邻的组织层）。
  • ⅠB期：胃癌：
  • 已在胃壁的黏膜层（最内层）形成癌细胞，并且可能已扩散到黏膜下层（与黏膜层相邻的组织层）。癌细胞已扩散至附近的1或2个淋巴结；或
  • 已在胃壁的黏膜层形成癌细胞，并已经扩散到了肌层。

    • Ⅱ期：

    Ⅱ期胃癌分为ⅡA期和ⅡB期。

  • ⅡA期：胃癌：
  • 可能已经扩散到胃壁的黏膜下层(与黏膜层相邻的一层组织)。癌细胞已扩散至附近3至6个淋巴结；或
  • 已经扩散到胃壁的肌层。癌细胞已扩散至附近的1或2个淋巴结；或
  • 已经扩散到胃壁的浆膜下层（与肌层相邻的结缔组织层）。
  • ⅡB期：胃癌：
  • 可能已经扩散到胃壁的黏膜下层（与黏膜层相邻的一层组织）。癌细胞已扩散至附近7至15个淋巴结；或
  • 已经扩散到胃壁的肌层。癌细胞已扩散至附近3至6个淋巴结;或
  • 已经扩散到胃壁的浆膜下层（与肌层相邻的结缔组织层）。癌细胞已扩散至附近的1或2个淋巴结；或
  • 已扩散至胃壁的浆膜层（最外层）。

    • Ⅲ期

    Ⅲ期胃癌分为ⅢA期、ⅢB期和ⅢC期。

  • Ⅲ期：癌细胞已经扩散至：
  • 胃壁的肌层。癌细胞已扩散至附近7至15个淋巴结；或
  • 胃壁的浆膜下层（与肌层相邻的结缔组织层）。癌细胞已扩散至附近3至6个淋巴结；或
  • 胃壁的浆膜层（最外层）。癌细胞已扩散至附近1至6个淋巴结；或
  • 到达邻近的器官，如脾脏、结肠、肝脏、膈肌、胰腺、腹壁、肾上腺、肾脏或小肠，或到腹腔的背侧。
  • ⅢB期：癌细胞：
  • 可能已经扩散到黏膜下层（与黏膜层相邻的组织层）或胃壁的肌层。癌细胞已扩散至附近的16个或更多个淋巴结；或
  • 已扩散至浆膜下层（与肌层相邻的结缔组织层）或胃壁的浆膜层（最外层）。癌细胞已扩散至附近7至15个淋巴结；或
  • 已由胃扩散至邻近器官，如脾脏、结肠、肝脏、膈肌、胰腺、腹壁、肾上腺、肾脏或小肠，或扩散至腹腔的背侧。癌细胞已扩散至附近1至6个淋巴结。
  • ⅢC期：癌细胞已经扩散至：
  • 胃壁的浆膜下层（与肌层相邻的结缔组织层），或浆膜层（最外层）。癌细胞已扩散至附近的16个或更多个淋巴结；或
  • 从胃进入附近的器官，如脾、结肠、肝脏，膈肌、胰腺、腹壁、肾上腺、肾脏、小肠，或腹腔的背侧。癌细胞已经扩散到附近的7个或更多淋巴结。

    • Ⅳ期

    在Ⅳ期，癌细胞已经扩散到人体的其他部位，如肺、肝脏、远处淋巴结和腹壁周围的组织。

    Gastric Cancer Treatment (PDQ®)

    Stages of Gastric Cancer

    After gastric cancer has been diagnosed, tests are done to find out if cancer cells have spread within the stomach or to other parts of the body.

    The process used to find out if cancer has spread within the stomach or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.

    The following tests and procedures may be used in the staging process:

  • Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body, usually through the mouth or rectum. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, abdomen, or pelvis, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. A PET scan and CT scan may be done at the same time. This is called a PET-CT.
  • MRI (magnetic resonance imaging) with gadolinium: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. A substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • Laparoscopy: A surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin, lighted tube) is inserted into one of the incisions. Other instruments may be inserted through the same or other incisions to perform procedures such as removing organs or taking tissue samples to be checked under a microscope for signs of cancer. A solution may be washed over the surface of the organs in the abdomen and then removed to collect cells. These cells are also looked at under a microscope to check for signs of cancer.

    • There are three ways that cancer spreads in the body.

    Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

    • Cancer may spread from where it began to other parts of the body.

    When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.

  • Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.

    • The metastatic tumor is the same type of cancer as the primary tumor. For example, if gastric cancer spreads to the liver, the cancer cells in the liver are actually gastric cancer cells. The disease is metastatic gastric cancer, not liver cancer.

    Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.

    The following stages are used for gastric cancer:

    Stage 0 (Carcinoma in Situ)

    In stage 0, abnormal cells are found in the mucosa (innermost layer) of the stomach wall. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

    Layers of the stomach wall. The wall of the stomach is made up of the mucosa (innermost layer), submucosa, muscle layer, subserosa, and serosa (outermost layer). The stomach is an organ in the upper abdomen.

    Stage I

    Stage I is divided into stages IA and IB.

  • Stage IA: Cancer has formed in the mucosa (innermost layer) of the stomach wall and may have spread to the submucosa (layer of tissue next to the mucosa).
  • Stage IB: Cancer:
  • has formed in the mucosa (innermost layer) of the stomach wall and may have spread to the submucosa (layer of tissue next to the mucosa). Cancer has spread to 1 or 2 nearby lymph nodes; or
  • has formed in the mucosa of the stomach wall and has spread to the muscle layer.

    • Stage II

    Stage II gastric cancer is divided into stages IIA and IIB.

  • Stage IIA: Cancer:
  • may have spread to the submucosa (layer of tissue next to the mucosa) of the stomach wall. Cancer has spread to 3 to 6 nearby lymph nodes; or
  • has spread to the muscle layer of the stomach wall. Cancer has spread to 1 or 2 nearby lymph nodes; or
  • has spread to the subserosa (layer of connective tissue next to the muscle layer) of the stomach wall.
  • Stage IIB: Cancer:
  • may have spread to the submucosa (layer of tissue next to the mucosa) of the stomach wall. Cancer has spread to 7 to 15 nearby lymph nodes; or
  • has spread to the muscle layer of the stomach wall. Cancer has spread to 3 to 6 nearby lymph nodes; or
  • has spread to the subserosa (layer of connective tissue next to the muscle layer) of the stomach wall. Cancer has spread to 1 or 2 nearby lymph nodes; or
  • has spread to the serosa (outermost layer) of the stomach wall.

    • Stage III

    Stage III gastric cancer is divided into stages IIIA, IIIB, and IIIC.

  • Stage IIIA: Cancer has spread:
  • to the muscle layer of the stomach wall. Cancer has spread to 7 to 15 nearby lymph nodes; or
  • to the subserosa (layer of connective tissue next to the muscle layer) of the stomach wall. Cancer has spread to 3 to 6 nearby lymph nodes; or
  • to the serosa (outermost layer) of the stomach wall. Cancer has spread to 1 to 6 nearby lymph nodes; or
  • to nearby organs, such as the spleen, colon, liver, diaphragm, pancreas, abdomen wall, adrenal gland, kidney, or small intestine, or to the back of the abdomen.
  • Stage IIIB: Cancer:
  • may have spread to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the stomach wall. Cancer has spread to 16 or more nearby lymph nodes; or
  • has spread to the subserosa (layer of connective tissue next to the muscle layer) or to the serosa (outermost layer) of the stomach wall. Cancer has spread to 7 to 15 nearby lymph nodes; or
  • has spread from the stomach to nearby organs, such as the spleen, colon, liver, diaphragm, pancreas, abdomen wall, adrenal gland, kidney, or small intestine, or to the back of the abdomen. Cancer has spread to 1 to 6 nearby lymph nodes.
  • Stage IIIC: Cancer has spread:
  • to the subserosa (layer of connective tissue next to the muscle layer) or to the serosa (outermost layer) of the stomach wall. Cancer has spread to 16 or more nearby lymph nodes; or
  • from the stomach into nearby organs, such as the spleen, colon, liver, diaphragm, pancreas, abdomen wall, adrenal gland, kidney, or small intestine, or to the back of the abdomen. Cancer has spread to 7 or more nearby lymph nodes.

    • Stage IV

    In stage IV, cancer has spread to other parts of the body, such as the lungs, liver, distant lymph nodes, and the tissue that lines the abdomen wall.

    胃癌的治疗(PDQ®)

    复发性胃癌

    复发性胃癌是指癌症在治疗之后再次出现。癌症可能在胃部或者身体的其他部位复发，例如肝脏或淋巴结。

    Gastric Cancer Treatment (PDQ®)

    Recurrent Gastric Cancer

    Recurrent gastric cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the stomach or in other parts of the body such as the liver or lymph nodes.

    胃癌的治疗(PDQ®)

    治疗方法概述

    对于胃癌患者而言，有多种不同的治疗方法。

    对于胃癌患者而言，有多种不同的治疗方法。有一些是标准治疗（目前正在使用的治疗方法），而有一些治疗方法则正在进行临床试验。临床试验是一种科学研究方法，其目的是改进当前的治疗方法，或者获取新的治疗方法的相关信息。当临床试验的结果显示新疗法优于标准疗法时，新的治疗方法可能会成为标准疗法。患者可能会考虑参与临床试验。一些临床试验只对尚未开始治疗的患者开放。

    目前使用的七种标准治疗方法：

    手术

    对于不同分期的胃癌患者而言，手术是一种常用的治疗方法。可以使用以下类型的手术：

  • 胃大部切除术：切除胃中带有肿瘤的部分、附近的淋巴结以及肿瘤附近一部分其他组织和器官。脾脏可能被切除。脾是一个产生淋巴细胞、储存红细胞和淋巴细胞、过滤血液和破坏衰老的血细胞的器官。脾脏位于腹腔左侧，靠近胃。
  • 全胃切除手术：切除整个胃，邻近的淋巴结以及部分食管、小肠和其他靠近肿瘤的组织。脾脏可能被切除。将食管和小肠进行重新连接，这样患者可以继续进食和吞咽。

    • 如果肿瘤造成了胃的堵塞，而常规手术不能够完全切除肿瘤，那么可以采取以下措施：

  • 腔内支架置入：通过植入支架（一个细小的可扩张的管状物）来保持通道（比如动脉或食管）的通畅。如果肿瘤堵塞了胃的入口或出口，可做通过手术在食管-胃连接处或胃-小肠连接处放置一个支架，让患者能够正常进食。
  • 腔内激光疗法：将带有激光发射器的内窥镜（一种能发光的细长的管状仪器）插入身体中。激光是一种高强度的光线束，可以像手术刀一样治疗肿瘤。
  • 胃空肠吻合术：通过手术来移除胃部堵住小肠入口的肿瘤。将胃和空肠（小肠的一部分）相连接，使食物和药可以通过胃进入小肠。

    • 内镜下黏膜切除术

    内镜下粘膜切除术是使用内窥镜切除消化道内壁的早期肿瘤和癌前病变，从而避免了手术。内窥镜是一种细长的管状仪器，带有灯和镜头，可观察消化道内的情况。通过它还可以使用工具来切除消化道内的增生物。

    化疗

    化疗是使用药物抑制癌细胞生长的治疗方法，药物可以杀死癌细胞或者阻止癌细胞分裂。当口服药物或者向血管或肌肉注射药物进行化疗时，药物能够进入到血流，然后到达全身的癌细胞（全身化疗）。当化疗药物直接注入到脑脊液中、器官中或体腔中，例如注入腹腔，药物会主要作用于这些区域的癌细胞（局部化疗）。进行化疗的方式主要取决于所治疗癌症的类型以及分期。

    目前正在研究的一种治疗胃癌的局部化疗方式是腹腔化疗（IP）。在腹腔化疗中，抗癌药物通过一根细管直接送至腹腔（容纳腹部器官的空间）。

    腹腔热灌注化疗（HIPEC）是一种正在研究的术中胃癌治疗方法。在外科医生尽可能多地切除肿瘤组织后，将加热的化疗药物直接送入腹腔。

    更多信息见已批准的治疗胃癌的药物。

    放射治疗

    放射疗法是一种使用高能x射线或其他类型的辐射杀死癌细胞或抑制癌细胞生长的癌症治疗方法。有两种类型的放射治疗方法:

  • 体外放射疗法是利用身体之外的机器将射线发送到肿瘤部位。
  • 体内放射疗法是将放射性物质密封在针、植入粒子、导丝或导管中，然后直接放置到癌症病灶内或病灶附近。

    • 采用的放射治疗方式取决于癌症的类型和分期。体外放射疗法被用于治疗胃癌。

    放化疗

    放化疗疗法是综合化学治疗和放射治疗来提高两者的效果。手术后进行放化疗，能够降低癌症复发的风险，这被称作辅助治疗。而当前正在研究在手术前进行放化疗来缩小肿瘤（即新辅助治疗）。

    靶向治疗

    靶向治疗是一种利用药物或其他物质来识别和攻击特定癌细胞的治疗方法，这种治疗方法不会损害正常细胞。单克隆抗体和多激酶抑制剂是用于治疗胃癌的靶向治疗方法。

  • 单克隆抗体疗法：这种治疗方法使用的是实验室中由一种类型的免疫系统细胞产生的抗体。这些抗体可以识别癌细胞上的物质或促使癌细胞生长的物质。抗体附着在这些物质上，杀死癌细胞，抑制癌细胞生长，或阻止癌细胞扩散。单克隆抗体通过注射给药。它们可以单独使用，也可以将药物、毒素或放射性物质直接运送到癌细胞中。

    • 有不同类型的单克隆抗体药物:

  • 曲妥珠单抗阻断生长因子蛋白HER2的作用，HER2可向胃癌细胞传递生长信号。
  • 雷莫芦单抗阻断某些蛋白质的作用，包括血管内皮生长因子。这有助于抑制癌细胞生长，并可能杀死它们。它还能阻止肿瘤生长所需的新生血管的生长。

    • 曲妥珠单抗和雷莫芦单抗可用于治疗Ⅳ期胃癌和不能手术切除或复发的胃癌。

  • 多激酶抑制剂：这是一种小分子药物，可以穿过细胞膜，在癌细胞内发挥作用，阻止癌细胞生长和分裂所需的多种蛋白质信号。一些多激酶抑制剂也有血管生成抑制剂的作用。血管生成抑制剂阻止肿瘤生长所需的新生血管的生长。

    • 有不同类型的多激酶抑制剂药物:

  • 瑞戈非尼是一种多激酶抑制剂和血管生成抑制剂，可阻断肿瘤细胞内多种蛋白的作用。目前正在研究瑞戈非尼治疗Ⅳ期胃癌和不能手术切除或复发性胃癌。

    • 更多信息见已批准的治疗胃癌的药物。

    免疫治疗

    免疫疗法是一种利用患者的免疫系统对抗癌症的治疗方法。由人体制造或实验室制造的物质被用来增强、引导或恢复人体对于癌症的天然防御力。这种癌症治疗方法也被称为生物疗法或生物治疗。

    免疫检查点抑制剂治疗是一种免疫疗法:

  • 免疫检查点抑制剂疗法：PD-1是T细胞表面的一种蛋白质，有助于控制人体的免疫反应。当PD-1附着在癌细胞上另一种称做PDL-1的蛋白质上时，它会阻止T细胞杀死癌细胞。PD-1抑制剂附着在PDL-1上，使T细胞能够杀死癌细胞。帕博利珠单抗是一种免疫检查点抑制剂。
    • 免疫检查点抑制剂。检查点蛋白，例如肿瘤细胞上的PD-L1和T细胞上的PD-1，有助于控制免疫反应。PD-L1与PD-1的结合阻止了T细胞杀死体内的肿瘤细胞（左图）。用免疫检查点抑制剂（抗PD-L1或抗PD-1）阻断PD-L1与PD-1的结合，使T细胞能够杀死肿瘤细胞（右图）。
    免疫疗法利用人体的免疫系统对抗癌症。这个动画解释了一种使用免疫检查点抑制剂来治疗癌症的免疫疗法。

    更多信息见已批准的治疗胃癌的药物。

    临床试验中正在验证新型的治疗方法。

    关于临床试验的相关信息可以在NCI网站获得。

    胃癌的治疗可能产生副作用。

    如想了解癌症治疗的副作用的信息，请参阅副作用页面。

    患者可能会考虑参与临床试验。

    对于一些患者而言，参与临床试验或许是治疗的最佳选择。临床试验属于癌症研究过程的一部分。临床试验的目的是检验新型的治疗方法是否安全，是否有效果或者是否优于标准疗法。

    许多目前的标准疗法都是基于早期的临床试验而确定的。参与临床试验的患者可能接受标准疗法或成为第一批接受新型疗法的人。

    参与临床试验的患者也能够帮助改善未来癌症的治疗方法。即使临床试验没能够带来有效的新的治疗方法，他们也能够解决一些重要的问题，并帮助促进研究的发展。

    患者可以在治疗前、治疗中或者治疗后参与临床试验。

    一些临床试验只限于尚未进行过治疗的患者参加。而其他一些试验治疗则是针对癌症没有好转的患者。也有一些临床试验是用来测试新的方法，来阻止癌症的复发或减少癌症治疗的副作用。

    临床试验正在全国许多地方进行。有关NCI支持的临床试验的信息，可在NCI的临床试验搜索网页上找到。其他组织支持的临床试验可以在ClinicalTrials.gov网站上找到。

    可能需要后续的检查。

    一些检查被重复进行，来诊断癌症或者明确癌症的分期。另一些检查被重复进行，来判断治疗的效果。测试的结果将会决定是否继续或改变或停止治疗。

    在治疗结束后，需要不时进行一些检测。检测的结果将会显示出病情是否改善或癌症是否复发。这些检查通常被称作后续检查或复查。

    还可能进行的其他检查：

  • 癌胚抗原（CEA）检测和CA19-9检测：通过检查样本，测定体内器官、组织或肿瘤细胞产生的某些物质的量。体内某些物质的水平升高往往与特定类型的癌症有关。这些物质被称为肿瘤标志物。当癌胚抗原（CEA）和CA19-9高于正常水平时，可能意味着胃癌治疗后出现了复发。
    • Gastric Cancer Treatment (PDQ®)

    Treatment Option Overview

    There are different types of treatment for patients with gastric cancer.

    Different types of treatments are available for patients with gastric cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Seven types of standard treatment are used:

    Surgery

    Surgery is a common treatment of all stages of gastric cancer. The following types of surgery may be used:

  • Subtotal gastrectomy: Removal of the part of the stomach that contains cancer, nearby lymph nodes, and parts of other tissues and organs near the tumor. The spleen may be removed. The spleen is an organ that makes lymphocytes, stores red blood cells and lymphocytes, filters the blood, and destroys old blood cells. The spleen is on the left side of the abdomen near the stomach.
  • Total gastrectomy: Removal of the entire stomach, nearby lymph nodes, and parts of the esophagus, small intestine, and other tissues near the tumor. The spleen may be removed. The esophagus is connected to the small intestine so the patient can continue to eat and swallow.

    • If the tumor is blocking the stomach but the cancer cannot be completely removed by standard surgery, the following procedures may be used:

  • Endoluminal stent placement: A procedure to insert a stent (a thin, expandable tube) in order to keep a passage (such as arteries or the esophagus) open. For tumors blocking the passage into or out of the stomach, surgery may be done to place a stent from the esophagus to the stomach or from the stomach to the small intestine to allow the patient to eat normally.
  • Endoluminal laser therapy: A procedure in which an endoscope (a thin, lighted tube) with a laser attached is inserted into the body. A laser is an intense beam of light that can be used as a knife.
  • Gastrojejunostomy: Surgery to remove the part of the stomach with cancer that is blocking the opening into the small intestine. The stomach is connected to the jejunum (a part of the small intestine) to allow food and medicine to pass from the stomach into the small intestine.

    • Endoscopic mucosal resection

    Endoscopic mucosal resection is a procedure that uses an endoscope to remove early-stage cancer and precancerous growths from the lining of the digestive tract without surgery. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also include tools to remove growths from the lining of the digestive tract.

    Chemotherapy

    Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

    A type of regional chemotherapy being studied to treat gastric cancer is intraperitoneal (IP) chemotherapy. In IP chemotherapy, the anticancer drugs are carried directly into the peritoneal cavity (the space that contains the abdominal organs) through a thin tube.

    Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment used during surgery that is being studied for gastric cancer. After the surgeon has removed as much tumor tissue as possible, warmed chemotherapy is sent directly into the peritoneal cavity.

    See Drugs Approved for Stomach (Gastric) Cancer for more information.

    Radiation therapy

    Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:

  • External radiation therapy uses a machine outside the body to send radiation toward the cancer.
  • Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

    • The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat gastric cancer.

    Chemoradiation

    Chemoradiation therapy combines chemotherapy and radiation therapy to increase the effects of both. Chemoradiation given after surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Chemoradiation given before surgery, to shrink the tumor (neoadjuvant therapy), is being studied.

    Targeted therapy

    Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibodies and multikinase inhibitors are types of targeted therapy used in the treatment of gastric cancer.

  • Monoclonal antibody therapy: This type of therapy uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.

    • There are different types of monoclonal antibody drugs:

  • Trastuzumab blocks the effect of the growth factor protein HER2, which sends growth signals to gastric cancer cells.
  • Ramucirumab blocks the effect of certain proteins, including vascular endothelial growth factor. This may help keep cancer cells from growing and may kill them. It may also prevent the growth of new blood vessels that tumors need to grow.

    • Trastuzumab and ramucirumab are used in the treatment of stage IV gastric cancer and gastric cancer that cannot be removed by surgery or has recurred.

  • Multikinase inhibitors: These are small-molecule drugs that go through the cell membrane and work inside cancer cells to block multiple protein signals that cancer cells need to grow and divide. Some multikinase inhibitors also have angiogenesis inhibitor effects. Angiogenesis inhibitors stop the growth of new blood vessels that tumors need to grow.

    • There are different types of multikinase inhibitor drugs:

  • Regorafenib is a multikinase inhibitor and angiogenesis inhibitor that blocks the effects of the multiple proteins inside tumor cells. Regorafenib is being studied in the treatment of stage IV gastric cancer and gastric cancer that cannot be removed by surgery or has recurred.

    • See Drugs Approved for Stomach (Gastric) Cancer for more information.

    Immunotherapy

    Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or biologic therapy.

    Immune checkpoint inhibitor therapy is a type of immunotherapy.

  • Immune checkpoint inhibitor therapy: PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. When PD-1 attaches to another protein called PDL-1 on a cancer cell, it stops the T cell from killing the cancer cell. PD-1 inhibitors attach to PDL-1 and allow the T cells to kill cancer cells. Pembrolizumab is a type of immune checkpoint inhibitor.
    • Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).
    Immunotherapy uses the body’s immune system to fight cancer. This animation explains one type of immunotherapy that uses immune checkpoint inhibitors to treat cancer.

    See Drugs Approved for Stomach (Gastric) Cancer for more information.

    New types of treatment are being tested in clinical trials.

    Information about clinical trials is available from the NCI website.

    Treatment for gastric cancer may cause side effects.

    For information about side effects caused by treatment for cancer, see our Side Effects page.

    Patients may want to think about taking part in a clinical trial.

    For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

    Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

    Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

    Patients can enter clinical trials before, during, or after starting their cancer treatment.

    Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

    Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

    Follow-up tests may be needed.

    Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

    Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

    Other tests may also be done:

  • Carcinoembryonic antigen (CEA) assay and CA 19-9 assay: A procedure in which a sample tissue is checked to measure the amounts of certain substances made by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called tumor markers. Higher than normal levels of carcinoembryonic antigen (CEA) and CA 19-9 may mean gastric cancer has come back after treatment.
    • 胃癌的治疗(PDQ®)

    根据分期选择治疗方案

    想要了解下面列表中的治疗方法，请参阅治疗方案概述部分。

    0期（原位癌）

    0期胃癌的治疗可能包括以下方式：

  • 手术（全胃切除术或胃大部切除术）。
  • 内镜黏膜切除术（EMR）。

    • 使用我们的临床试验搜索，您可以查找在NCI支持的癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的基本信息。

    I期胃癌

    Ⅰ期胃癌的治疗可能包括以下方式：

  • 手术（全胃切除术或胃大部切除术）。
  • 某些IA期胃癌患者可采用内镜黏膜切除术。
  • 手术（全胃切除术或胃大部切除术）前进行放化疗。
  • 一项在手术前给予放化疗的临床试验。

    • 使用我们的临床试验搜索，您可以查找在NCI支持的癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的基本信息。

    Ⅱ期和Ⅲ期胃癌

    Ⅱ期和Ⅲ期胃癌的治疗可能包括以下方式：

  • 手术（全胃切除术或胃大部切除术）。
  • 术前化疗
  • 手术（全胃切除术或胃大部切除术）前进行放化疗。
  • 一项在手术前给予放化疗的临床试验。
  • 一项在手术前给予化疗的临床试验。

    • 使用我们的临床试验搜索，您可以查找在NCI支持的癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的基本信息。

    Ⅳ期胃癌，不能手术切除的胃癌，和复发性胃癌

    Ⅳ期胃癌，不能手术切除的胃癌，和复发性胃癌的治疗可能包括以下方式：

  • 化疗作为姑息性治疗，可以缓解症状并且提高患者生活质量
  • 单克隆抗体靶向治疗，联合或不联合化疗。
  • 免疫治疗。
  • 腔内激光治疗和腔内支架置入术可以缓解胃梗阻症状，胃空肠吻合旁路手术也可以缓解胃梗阻症状。
  • 放射治疗作为一种姑息性治疗，可以止血，减轻疼痛，或让引起胃梗阻的肿瘤缩小。
  • 外科手术作为一种姑息性治疗，可以止血或者让引起胃梗阻的肿瘤缩小。
  • 一项化疗新组合的临床试验作为姑息性治疗，可以缓解临床症状，并且提高生活质量。
  • 一项多激酶抑制剂靶向治疗的临床试验。
  • 一项手术和腹腔热灌注化疗（HIPEC）的临床试验。

    • 使用我们的临床试验搜索，您可以查找在NCI支持的癌症临床试验中，有哪些目前正在招募患者。您可以根据癌症类型、患者年龄和试验地点，搜索临床试验。您还可以获得有关临床试验的基本信息。

    Gastric Cancer Treatment (PDQ®)

    Treatment Options by Stage

    For information about the treatments listed below, see the Treatment Option Overview section.

    Stage 0 (Carcinoma in Situ)

    Treatment of stage 0 may include the following:

  • Surgery (total or subtotal gastrectomy).
  • Endoscopic mucosal resection.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage I Gastric Cancer

    Treatment of stage I gastric cancer may include the following:

  • Surgery (total or subtotal gastrectomy).
  • Endoscopic mucosal resection for certain patients with stage IA gastric cancer.
  • Surgery (total or subtotal gastrectomy) followed by chemoradiation therapy.
  • A clinical trial of chemoradiation therapy given before surgery.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stages II and III Gastric Cancer

    Treatment of stage II gastric cancer and stage III gastric cancer may include the following:

  • Surgery (total or subtotal gastrectomy).
  • Chemotherapy given before surgery.
  • Surgery (total or subtotal gastrectomy) followed by chemoradiation therapy or chemotherapy.
  • A clinical trial of chemoradiation therapy given before surgery.
  • A clinical trial of chemotherapy given before surgery.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage IV Gastric Cancer, Gastric Cancer That Cannot Be Removed By Surgery, and Recurrent Gastric Cancer

    Treatment of stage IV gastric cancer, gastric cancer that cannot be removed by surgery, or recurrent gastric cancer may include the following:

  • Chemotherapy as palliative therapy to relieve symptoms and improve the quality of life.
  • Targeted therapy with a monoclonal antibody with or without chemotherapy.
  • Immunotherapy.
  • Endoluminal laser therapy or endoluminal stent placement to relieve a blockage in the stomach, or gastrojejunostomy to bypass the blockage.
  • Radiation therapy as palliative therapy to stop bleeding, relieve pain, or shrink a tumor that is blocking the stomach.
  • Surgery as palliative therapy to stop bleeding or shrink a tumor that is blocking the stomach.
  • A clinical trial of new combinations of chemotherapy as palliative therapy to relieve symptoms and improve the quality of life.
  • A clinical trial of targeted therapy with a multikinase inhibitor.
  • A clinical trial of surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    胃癌的治疗(PDQ®)

    了解更多关于胃癌的信息。

    想要从国家癌症研究所了解更多关于胃癌的信息，请参阅下列内容：

  • 胃癌主页
  • 胃癌预防
  • 胃癌筛查
  • 儿童罕见癌症的治疗方法
  • 癌症治疗中的激光技术
  • 已批准用于治疗胃癌的药物
  • 吸烟（包括帮助如何戒烟）
  • 幽门螺杆菌与癌症的关系

    • 想要从国家癌症研究所获得一般癌症信息和其他资源，请参阅下列内容：

  • 关于癌症
  • 分期
  • 化疗与您：为癌症患者提供支持
  • 放疗与您：为癌症患者提供支持
  • 应对癌症
  • 向医生询问有关癌症的问题
  • 幸存者和照顾者
    • Gastric Cancer Treatment (PDQ®)

    To Learn More About Gastric Cancer

    For more information from the National Cancer Institute about gastric cancer, see the following:

  • Stomach (Gastric) Cancer Home Page
  • Stomach (Gastric) Cancer Prevention
  • Stomach (Gastric) Cancer Screening
  • Unusual Cancers of Childhood Treatment
  • Lasers in Cancer Treatment
  • Drugs Approved for Stomach (Gastric) Cancer
  • Tobacco (includes help with quitting)
  • Helicobacter pylori and Cancer

    • For general cancer information and other resources from the National Cancer Institute, see the following:

  • About Cancer
  • Staging
  • Chemotherapy and You: Support for People With Cancer
  • Radiation Therapy and You: Support for People With Cancer
  • Coping with Cancer
  • Questions to Ask Your Doctor about Cancer
  • For Survivors and Caregivers
    • 胃癌的治疗(PDQ®)

    About This PDQ Summary

    About PDQ

    Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

    PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

    Purpose of This Summary

    This PDQ cancer information summary has current information about the treatment of gastric cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

    Reviewers and Updates

    Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

    The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

    Clinical Trial Information

    A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

    Permission to Use This Summary

    PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

    The best way to cite this PDQ summary is:

    PDQ® Adult Treatment Editorial Board. PDQ Gastric Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated . Available at: https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq. Accessed . [PMID: 26389328]

    Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

    Disclaimer

    The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

    Contact Us

    More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.

    Gastric Cancer Treatment (PDQ®)

    About This PDQ Summary

    About PDQ

    Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

    PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

    Purpose of This Summary

    This PDQ cancer information summary has current information about the treatment of gastric cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

    Reviewers and Updates

    Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

    The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

    Clinical Trial Information

    A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

    Permission to Use This Summary

    PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

    The best way to cite this PDQ summary is:

    PDQ® Adult Treatment Editorial Board. PDQ Gastric Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated . Available at: https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq. Accessed . [PMID: 26389328]

    Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

    Disclaimer

    The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

    Contact Us

    More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.

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    目录
    章 节
    胃癌的基本信息 胃癌分期 复发性胃癌 治疗方法概述 根据分期选择治疗方案 了解更多关于胃癌的信息。 About This PDQ Summary
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