(1) radical operation
Its principle is to remove part or all of the stomach, including cancer focus and possibly infiltrated stomach wall, and to remove lymph nodes around the stomach according to clinical staging standards to rebuild the digestive tract.
(2) Palliative surgery
The primary focus can not be removed, and the symptoms caused by complications such as obstruction, perforation and bleeding can be relieved by surgery, such as gastrojejunostomy, jejunostomy and perforation repair.
2. Chemotherapy
It can be used before, during and after radical surgery to prolong the survival time. Appropriate chemotherapy for patients with advanced gastric cancer can slow down the development of tumor and improve symptoms, which has a certain short-term effect. In principle, adjuvant chemotherapy is not needed after radical gastrectomy for early gastric cancer, but should be given in the following cases: (1) The pathological type is highly malignant; The area of cancer focus is more than 5 cm; Multiple cancer lesions; Under 40 years old. Patients with advanced gastric cancer after radical operation, palliative operation and recurrence after radical operation need chemotherapy.
The common chemotherapy methods for gastric cancer are oral administration, intravenous administration, intraperitoneal administration and arterial infusion. Commonly used oral chemotherapy drugs are tegafur, Youfuding, fluoride iron and so on. Commonly used intravenous chemotherapy drugs include fluorouracil, mitomycin, cisplatin, amoxicillin, etoposide, calcium formyltetrahydrofolate and so on. In recent years, new chemotherapeutic drugs such as paclitaxel, platinum oxalate, topoisomerase inhibitor and xeloda have been used for gastric cancer.
3. Other treatments
Including radiotherapy, hyperthermia, immunotherapy, traditional Chinese medicine treatment and so on. Immunotherapy for gastric cancer includes nonspecific biological response regulators, such as BCG and lentinan. Cytokines such as interleukin, interferon, tumor necrosis factor, etc. And the clinical application of adoptive immunotherapy such as lymphocyte activated killer cells (IAK) and tumor infiltrating lymphocytes (TIL). Antiangiogenic gene is a widely studied gene therapy method, which may play a role in the treatment of gastric cancer.