What treatment plan is recommended for a patient with gastric adenocarcinoma (胃部腺癌) after total gastrectomy (全胃切除手术) with no metastasis (转移) shown on Positron Emission Tomography (PET) scan?

From the Guidelines

对于胃部腺癌全胃切除手术后，PET检查未发现转移的患者，建议采用辅助化疗方案 [ 1 ].

推荐治疗方案

• 卡培他滨（Capecitabine）或奥沙利铂（Oxaliplatin）联合氟尿嘧啶（5-FU）是常见的辅助化疗方案 [ 1 ]。
• 具体治疗方案为：卡培他滨（Capecitabine）1000mg/m²，口服，连续14天，每21天为一个周期，共6个周期；或奥沙利铂（Oxaliplatin）130mg/m²，静脉注射，第1天， 每21天为一个周期，共6个周期，联合氟尿嘧啶（5-FU）400mg/m²，静脉注射，第1天，及2000mg/m²，静脉滴注，第1-3天。

监测和随访

• 建议密切随访，监测患者的肿瘤标志物和影像学检查结果 [ 1 ]。
• 在辅助化疗完成后，应继续监测患者的长期治疗相关并发症 [ 1 ]。

个体化治疗

• 根据患者的具体情况，医生可能会选择不同的治疗方案或调整剂量和治疗周期 [ 1 ]。
• 医生应根据患者的反应和耐受性调整治疗计划 [ 1 ].

From the FDA Drug Label

1. 4 Recommended Dosage for Gastric Adenocarcinoma • The recommended dose of fluorouracil, administered as a component of a platinum-containing multidrug chemotherapy regimen, is 200 mg/m2 to 1000 mg/m2 intravenously as a continuous infusion over 24 hours. The frequency of dosing in each cycle and the length of each cycle will depend on the dose of fluorouracil and the specific regimen administered.

The treatment plan recommended for a patient with gastric adenocarcinoma after total gastrectomy with no metastasis shown on PET scan is fluorouracil as part of a platinum-containing multidrug chemotherapy regimen, with a dose of 200 mg/m2 to 1000 mg/m2 administered as a continuous infusion over 24 hours 2.

• The frequency of dosing and length of each cycle will depend on the dose of fluorouracil and the specific regimen administered.
• Dose modifications may be necessary based on the patient's response to treatment and the development of adverse reactions.