引用文本：唐维, 陈剑辉, 翟二涛, 等. 第7版《日本胃癌治疗指南》支持与姑息治疗部分更新要点解读[J/CD]. 消化肿瘤杂志（电子版）, 2025, 17(2):141-147.

作者：唐维¹，陈剑辉¹，翟二涛¹，褚忠华²

单位：1. 中山大学附属第一医院 胃肠外科中心，广东 广州 510080；2. 中山大学孙逸仙纪念医院 胃肠外科，广东 广州 510120

Authors：Tang Wei¹, Chen Jianhui¹, Zhai Ertao¹, Chu Zhonghua²

Unit：1. Gastrointestinal Surgery Center, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080 Guangdong, China；2.      Department of Gastrointestinal Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120，Guangdong, China

摘要：

2025年3月，第7版《日本胃癌治疗指南》正式发布。本文聚焦该指南中新增的“支持与姑息治疗”部分，探讨其涉及的两个临床问题：其一，针对尚未进入难治性恶病质的晚期胃癌患者，阿那莫林通过激动胃饥饿素受体，可增加体重、改善食欲并提升生活质量，为多学科综合干预提供了有力的药物支持；其二，对于出血性晚期胃癌患者，姑息性放疗以其低侵袭性和良好耐受性，可期待其在70%~80%的病例中实现有效止血，并在缓解症状、减少输血需求及为后续全身治疗创造条件方面发挥重要作用。尽管这两项推荐均为弱推荐，且相关高质量证据尚待进一步补充，但在缺乏更优替代方案的情况下，这些策略为临床实践提供了切实可行的指导。

关键词：胃癌；支持与姑息治疗；阿那莫林；放疗

Abstract：

In March 2025, the 7th edition of the Japanese gastric cancer treatment guidelines was officially published. This review focuses on the newly added “supportive and palliative care” section, examining two key clinical questions. First, in patients with advanced gastric cancer who have not yet progressed to refractory cachexia, Anamorelin—a ghrelin receptor agonist—can increase body mass, improve appetite, and enhance quality of life, thereby providing potent pharmacologic support for multidisciplinary interventions. Second, in bleeding advanced gastric cancer, palliative radiotherapy—owing to its low invasiveness and good tolerability—is expected to achieve effective hemostasis in 70%-80% of cases and plays a critical role in symptom relief, reducing transfusion requirements, and paving the way for subsequent systemic therapy. Although both strategies carry only weak recommendations and higher‑quality evidence remains needed, they offer practical guidance for clinical practice in the absence of superior alternatives.

Key words：Gastric cancer; Supportive and palliative care; Anamorelin; Radiotherapy

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