B6. Radiotherapy, surgical, and pharmacological treatment of gastric cancer  Flashcards Preview

Oncology > B6. Radiotherapy, surgical, and pharmacological treatment of gastric cancer  > Flashcards

Flashcards in B6. Radiotherapy, surgical, and pharmacological treatment of gastric cancer  Deck (14):
1

What are the general principles of treatment

Radical surgery means curative treatment.
Chemo and radiotherapy can be given as adjuvant

2

When to use chemo and chemoradiotherapy in gastric cancer

-Perioperative chemotherapy (3 sessions before surgery and 3 after surgery)
-perioperative chemoradiotherapy

3

What is done for T1a stage surgical tumors?

Endoscopic mucosal dissection or endoscopic submucosal dissection

4

What is done in T1b & T2-3 N0 gastric tumors

Total gastrectomy with D2 lymphadenectomy in perigastric area, hepatoduodenal ligament, and pancrease/spleen axis. (Maybe cardia can be preserved)

5

What is the surgical treatment for T3 N1-2 Mo gastric tumors

Chemotherapy before gastrectomy with D2 lymphadenectomy

6

M1 gastric cancer surgical treatment

Only radical surgery

7

Options for reconstruction after gastrectomy

-Roux-Y
-Jejunal interposition
-jejunal interposition with pouch

8

Radiotherapy is given when with gastric cancer?

-Preoperative chemoradiotherapy given to down stage unresectable tumor
-postop chemoradiotherapy given to patient who has received it preoperatively, patient didn’t receive lymphadenectomy, # of removed lymph nodes was less than 15, surgical margins was positive for tumor cells

9

Drug therapy for gastric cancers perioperatively

Fluoropyrimidine and platinum or triple combo with anthracycline (2-3 months)

10

Drug therapy for gastric cancers adjuvant treatment

Fluropyrimidine +platinum to eradicate tumor cells from bloodstream (successful surgery with no metastasis)

11

Drug treatment of inoperable gastric cancer

Fluoropyrimidine+platinum+anthracycline
Treatment of elderly (capacitabin + oxaliplatin)

12

Her-2 positive tumor treatment

Trastuzumab + fluoropyrimidine + platinum

13

PDL1 receptor gastric tumor

Pembrolizumab

14

Follow with gastric tumor

-B12 and iron supplement. Vaccination in case of splenectomy
-1st year: every 3rd month, 2nd year every 6th month, 3rd year: anual checks