Oncology Frontier: Could you tell us how we can best balance the therapeutic effect of palliative chemotherapy and the life quality of gastric cancer patients?

　　《肿瘤瞭望》：如何兼顾姑息化疗的疗效与患者的生活质量？

　　Dr Hironaka: Gastric cancer patients sometimes suffer from abdominal pain and back pain， abdominal distension and ascites and so on. Control of pain and the other symptoms using medication should be started and is a very important part of the treatment of patients with any symptom.

　　Hironaka博士：胃癌患者有时会出现腹痛、背部疼痛、腹胀、腹水等。应该使用药物控制疼痛和其他症状，这对于出现这些症状的患者，是治疗的一个非常重要的组成部分。

　　Oncology Frontier: Could you talk about the predictive biomarkers for palliative chemotherapy of gastric cancer?

　　《肿瘤瞭望》：胃癌姑息化疗疗效的预测因子有哪些？

　　Dr Hironaka: Many clinical studies are ongoing but one available biomarker is HER2. Already， individualized treatment for HER2 is a standard in clinical practice using trastuzumab. Other biomarkers， such as EGFR and c-MET， are now under investigation in clinical phase III studies. So we are waiting for those results.

　　Hironaka博士：许多临床研究正在进行，目前只有一个可用的生物标志物HER-2。目前，在临床实践中，针对HER-2的个体化治疗标准是使用曲妥珠单抗。其他生物标志物，如EGFR和c-MET，现在正处于Ⅲ期临床研究。我们正在等待这些结果。

　　Oncology Frontier: When we choose suitable chemotherapy drugs during palliative chemotherapy， which factors should we take into consideration?

　　《肿瘤瞭望》：当我们选择合适的姑息性化疗药物时，应该考虑哪些因素？姑息化疗同其他阶段的化疗有哪些不同？

　　Dr Hironaka: When starting chemotherapy， patient selection is very important. For example， patients with poor oral intake (performance status of 3 or more) should not be treated. In the case of adjuvant therapy particularly， many patients lose body weight after surgery because of poor oral intake. For these patients， we take care of adverse events after starting chemotherapy and dose reduction can be very important.

　　Hironaka博士：是否进行化疗，患者的状态是非常重要的。例如，患者口服摄入差（3个或更多的表现）则不应进行化疗。尤其是在辅助治疗时，很多患者由于进食不佳，术后体重下降。对于这些患者，我们要在化疗开始后就要注意针对化疗的不良事件进行处理，降低剂量十分重要。