Early stomach cancer is asymptomatic or only has slight symptoms. When the clinical symptoms are obvious, the disease is already in the advanced stage. Therefore, we should be very alert to the early symptoms of stomach cancer so as to avoid delay in diagnosis and treatment 1. Symptoms (1) Early stomach cancer: With the development of the disease, the function of the stomach and the surrounding conditions gradually change, and these symptoms are often non-specific, which can be hidden from time to time and exist for a long time. For example, epigastric distension, dull pain, hidden pain, nausea, loss of appetite, belching and emaciation, etc. A few ulcerative type (type IIc and type III) early gastric cancers may also have ulcer-like symptoms, rhythmic pain, acid reflux, which can be relieved by internal medicine treatment. In some patients, stomach cancer and certain benign lesions*** exist or develop on the basis of certain benign lesions (e.g. chronic atrophic gastritis, peptic ulcer, etc.), and the symptoms of these benign gastric diseases have existed for a long period of time or recurring, which is more likely to relax the vigilance of the patients and doctors to stomach cancer, and delay the time of diagnosis. Certain early gastric cancer may also appear symptoms such as vomiting blood, black stool, or difficulty in swallowing and consult the doctor. Epigastric discomfort: it is the most common initial symptom of gastric cancer, about 80% of patients have this symptom, which is similar to indigestion. If abdominal pain occurs, it is usually mild and irregular at the beginning, and it cannot be relieved after eating, and gradually aggravates, and it can be hidden pain or dull pain. Some of them may have rhythmic pain, especially gastric cancer of gastric sinus, which is more obvious, and even can be relieved by eating or taking medicine. Elderly people have dull pain sensation and mostly complain of abdominal distension. These symptoms are often not emphasized by patients, and they are easily mistaken as gastritis or ulcer disease when seeking medical treatment. Therefore, middle-aged patients with the following conditions should be given further examination, so as not to miss the diagnosis: A. No previous history of gastric disease, but the recent occurrence of unexplained epigastric discomfort or pain, after the treatment is ineffective; B. Previous history of gastric ulcer, the recent change in the regularity of epigastric pain, and the degree of increasing. If the symptoms are relieved, but there is recurrence in a short period of time, the possibility of gastric cancer should be considered, and further examination should be carried out in time. Loss of appetite: loss of appetite and lethargy are the second most common symptoms of stomach cancer. Nearly 50% of stomach cancer patients have obvious symptoms of loss of appetite or loss of appetite, and some of the patients limit their food intake on their own due to abdominal distension or abdominal pain caused by eating too much. Unexplained anorexia and lethargy are probably the initial symptoms of early gastric cancer, which need to be taken seriously. Early gastric cancer patients usually have no obvious positive signs, and most of them only have deep pressure pain in the upper abdomen besides weak general condition. (2) Progressive gastric cancer: gastric cancer lesion is a gradual process from small to big, from shallow to deep, from no metastasis to metastasis, therefore, there is no obvious boundary between early stage, progressive stage and even late stage, not only this, but also there is often a great intersection of symptoms between the stages. Some patients consult the doctor with symptoms of organ metastasis or comorbidities. According to the statistics of domestic data, the common symptoms of advanced gastric cancer are as follows: ①Abdominal pain: when the gastric cancer develops and expands, especially when the infiltration penetrates the plasma membrane and invades the pancreas or transverse colonic mesentery, persistent and severe pain may appear and radiate to the back of waist. Very few patients with perforated cancerous ulcers may also have severe abdominal pain and signs of peritoneal irritation. (ii) Loss of appetite and emaciation: absorption of toxins from cancerous tumors can make patients increasingly show emaciation, weakness, anemia and malnutrition, which often aggravates progressively and finally manifests as malignant disease. (iii) Nausea and vomiting: it is also one of the more common symptoms, which can occur in early stage. Cancer of gastric sinus can also present the symptom of pyloric obstruction. (iv) Vomiting blood and black stool: when ulcer is formed on the surface of cancer, vomiting blood and black stool will appear. 1/3 of gastric cancer patients often have small amount of bleeding, which is mostly manifested as positive fecal occult blood, and some of them may have intermittent black stool, but there are some patients who consult the doctor for large amount of vomiting blood. Diarrhea: it may be related to low gastric acid, and the stools may be paste-like or even have diarrhea. When advanced gastric cancer involves the colon, it may cause diarrhea and bloody stools. (6) Difficulty in swallowing: after the cancer grows up, obstruction symptoms may appear, cardia or fundus cancer may cause difficulty in swallowing, and gastric sinus cancer may cause pyloric obstruction symptoms. 2. Signs and symptoms: Early gastric cancer may not have any signs and symptoms. Early gastric cancer may not have any physical signs, or only have pressure and pain in the upper abdomen. In middle and late gastric cancer, most of the patients have obvious epigastric pressure pain, and 1/3 of them can feel the mass in the abdomen, which is hard, with non-smooth surface and tenderness, especially the slim patients suffering from gastric sinus cancer are more likely to find the mass. As for metastatic foci such as palpable mass in front of rectum, umbilical mass, enlarged supraclavicular lymph nodes and ascites, they are even more evidence of advanced gastric cancer. Epigastric mass, anterior rectal crypt mass, umbilical mass, enlarged left supraclavicular lymph node, enlarged left axillary lymph node and ascites often suggest that distant metastases have been present. And often due to the different sites of metastasis, corresponding signs appear, which makes the clinical manifestation very complicated. For example, liver metastasis can show hepatomegaly and jaundice, ovarian metastasis can show enlarged ovaries and large amount of ascites, and lung metastasis can show respiratory difficulty. In addition, gastric cancer with cancer syndrome can also be important signs, such as thrombophlebitis, dermatomyositis and so on. Patients with advanced stage may have fever and malignant disease. Traditional Chinese medicine treatment for stomach cancer Traditional Chinese medicine treatment Surgery is unlikely for middle and late stage stomach cancer, even if surgery can be performed, it is only palliative local resection. Clinically, the treatment of middle and late stage stomach cancer mostly adopts radiotherapy combined with traditional Chinese medicine as a comprehensive means to fully combine the advantages of each treatment method. Stomach cancer is one of the common malignant tumors. The common symptoms of stomach cancer are epigastric discomfort or epigastric pain, which tends to intensify after eating, and with the progress of disease, the pain intensifies, has frequent attacks and radiates to the back of waist, and is often accompanied by symptoms such as loss of appetite, fatigue, nausea and vomiting, heartburn in the stomach, yellowish color, and emaciation, etc. According to Chinese medicine, this disease is mostly belongs to the category of middle and late stage gastric cancer. According to Chinese medicine, this disease mostly belongs to the category of "regurgitation" and "gastric pain". The pathogenesis of the disease is due to uncontrolled diet, excessive worry, damage of spleen and stomach, failure of transportation and digestion, internal growth of phlegm and dampness, and accumulation of qi and phlegm for a long period of time. Chinese herbal medicine for cancer treatment has the following characteristics: 1. Strong overall concept. Although the tumor grows in a certain part of the body, it is actually a systemic disease. For most of the tumor patients, local treatment cannot solve the problem of eradication, while Chinese medicine has an important role in improving the local symptoms and systemic condition of the patients due to the implementation of diagnosis and treatment from the overall concept, which not only takes into account the local treatment, but also adopts the method of correcting and cultivating the root of the disease. 2、It can make up for the deficiencies of surgical treatment, radiotherapy and chemotherapy. Surgery can certainly remove the cancer, but there is still residual cancer, or regional lymph node metastasis, or the presence of cancer thrombus in blood vessels, etc. Long-term postoperative treatment with TCM can prevent recurrence and metastasis; radiotherapy and chemotherapy have considerable side effects on the digestive tract and hematopoietic system, so TCM treatment can not only alleviate the side effects of radiotherapy and chemotherapy, but also strengthen the effect of radiotherapy and chemotherapy. For advanced cancer patients or those who cannot undergo surgery and radiotherapy or chemotherapy, traditional Chinese medicine can be used. 3. It does not affect the labor force. While the local condition of cancer patients improves, the general condition also improves. Side effects are small. According to Chinese medicine, this disease mostly belongs to the category of "regurgitation" and "gastric pain". The mechanism of the disease is due to uncontrolled diet, excessive worry, damage to spleen and stomach, failure of transportation and digestion, internal growth of phlegm and dampness, and accumulation of gas and phlegm for a long time. Western medical treatment for stomach cancer Surgical treatment Due to the continuous improvement of diagnosis level, the rise of early detection rate of stomach cancer, coupled with the continuous improvement of surgical methods, and the cooperative application of chemotherapy, radiotherapy and biological agents, the overall level of treatment for stomach cancer in recent years has been significantly improved. According to the data in recent years, the 5-year survival rate of early gastric cancer in Japan and western countries can reach more than 90%, and the overall 5-year survival rate of gastric cancer after surgery in Japan has reached more than 60%. According to recent data, the 5-year survival rate of early gastric cancer in Japan and western countries can almost reach more than 90%, and the overall 5-year survival rate of Japanese gastric cancer after surgery has reached more than 60%. 1. Surgical treatment Surgery is still the main method of treating gastric cancer at present. For a long time, due to the late detection of gastric cancer, most of them belong to advanced stage tumors, the surgical efficacy is poor, and the 5-year survival rate after surgery has been maintained at about 30%. Therefore, it is necessary to strengthen the attention to the symptoms of early gastric cancer and the monitoring of high-risk groups, so as to improve the detection rate of early gastric cancer. In recent years, due to the advancement of anesthesia and pre- and post-surgical resection treatment, the safety of surgery can be improved, and at the same time, there is a lack of diagnostic methods that can correctly determine the possibility of gastric cancer resection before surgery, therefore, as long as the patient's general condition permits, and there is no clear distant metastasis, surgical exploration should be carried out in order to strive for resection. As for the choice of surgery, different surgical methods should be decided according to the clinicopathological staging of the tumor and intraoperative findings, including the location of gastric cancer, tumor size, depth of infiltration and lymph node enlargement. Arbitrarily expanding or reducing the scope of surgical resection, causing excessive destruction of organ function or postoperative tumor recurrence are inappropriate. Surgery can be divided into two categories: radical resection and palliative surgery. The development trend of modern surgical treatment of gastric cancer is that the surgical scope of progressive gastric cancer tends to be expanded, and extended or super-expanded surgery can be performed, while the surgical scope of early gastric cancer tends to be narrowed, and various surgeries with resection scope of about 5% can be performed. The selection of specific surgical methods tends to be "tailor-made", based on the patient's general status and the pathophysiology of the cancer to select appropriate surgical methods. (1) Radical resection: The basic requirement of radical resection is to completely remove the primary foci of gastric cancer, metastatic lymph nodes and infiltrated tissues. In order to completely remove regional lymph nodes, it is often necessary to cut off all supplying arteries of stomach at the root, and after all arteries are cut off, it is necessary to perform total gastrectomy, and it is often necessary to cut off the body of pancreas, tail of pancreas and spleen together. The body of the pancreas, the tail of the pancreas and the spleen must also be removed. Therefore, at present, two types of operation are generally used, i.e. radical subtotal gastrectomy and radical total gastrectomy. Although total gastrectomy can facilitate the complete removal of lymph nodes and prevent the recurrence of gastric stump due to incomplete resection, it has the disadvantages of high operative mortality, postoperative complications and long-term nutritional disorders, and the five-year survival rate cannot be significantly improved after surgery. Therefore, the choice of radical subtotal gastrectomy and radical total gastrectomy is still divergent, and it is generally advocated that it should be based on the site of the tumor, the extent of infiltration and the technical conditions of the hospital, in principle, it is possible to completely remove the tumor and avoid unnecessary expansion of the surgical scope. As for the scope of lymph node dissection in radical resection, it can be very different in practice. Where the scope of lymph node dissection exceeds the actual involvement of lymph nodes, it is absolute radical resection, while only removing the actual involved lymph nodes is relative radical resection. Summarizing the relevant data in recent years in China, there are two noteworthy problems in the surgical treatment of gastric cancer: one is that the number of cases of total gastrectomy is relatively small, which generally accounts for only about 5% of the total number of resection cases; the other is that the current radical surgery in many units is only the R1 surgery, while the current hospitalized cases of stage III and IV gastric cancer in China amount to 56%-90%. Obviously, the scope of surgical resection in many cases is insufficient, and due to the insufficient radicality of surgery, there are tumor foci remaining, so as to affect the efficacy. According to domestic and foreign experiences, the choice of radical resection and the scope of lymph node dissection in practice can be determined according to the following specific conditions. ① Radical resection should actively and cautiously expand the cases of total gastrectomy in units with technical conditions. The indications for surgery should be strictly controlled in: A. Invasive gastric cancer. B.Gastric body cancer with plasma membrane infiltration and lymph node metastasis. C. Cancer of the distal or proximal part of the stomach with a high degree of malignancy, with second-stage lymph node metastasis or with invasion of the gastric body. Total gastrectomy shall not be performed for those who cannot be cured radically or whose systemic conditions do not allow it. ②The treatment of early gastric cancer should choose different methods according to the size of lesion and depth of infiltration. Early gastric cancer used to advocate R2 operation, but with the accumulation of experience, it is found that the survival rate of early gastric cancer with single lesion is not only high, but also the recurrence rate is low (2.8%), and the recurrence cases are the ones whose lesions invade into the submucosal layer with lymphatic metastasis, and the recurrence is mostly in the form of hematogenous metastasis to the lungs and the liver. The survival rate of early gastric cancer with lesions limited to the mucous layer can reach 100% even if the first lymph node metastasis has already occurred, no matter it is single or multiple lesions. In addition, all polypoid intramucosal cancers (I and IIa) had no lymph node metastasis and all of them survived after surgery. Therefore, it is believed that the surgical methods of early gastric cancer should be revised. Generally speaking, R1 surgery is appropriate for intramucosal cancer and R2 surgery is appropriate for submucosal cancer. For polypoid intramucosal cancer smaller than 2cm, local excision of tumor or R0 operation is sufficient. As the early gastric cancer without ulcer or only with ulcer scar in diameter <2cm basically has no lymphatic metastasis, endoscopic laser treatment can be carried out, and for the lesion of <1cm, electric knife can be used for local excision of mucosa. For radical cases that do not belong to the above two categories, R2-based operation is preferred. There is a report comparing the efficacy of R1 and R2 radical surgery for stage III gastric cancer, and the 5-year survival rate of R2 surgery is significantly higher than that of R1 surgery. When gastric cancer directly invades into neighboring tissues and organs, if possible, the whole piece should be resected at the same time with radical gastrectomy, and there is still a chance of cure. It has been reported that the efficacy of additional organ resection is second only to that of distal gastric cancer, and better than proximal resection and total gastrectomy. Therefore, as long as there is no distant metastasis, the chance of radical treatment should not be given up. Generally, resection of spleen, body of pancreas, tail of pancreas, transverse colon or left lobe of liver is the most common, and the operative mortality rate of combined resection of head of pancreas and duodenum is quite high, and the 5-year survival rate is also the worst (5%), therefore, it should not be taken lightly. (2) Palliative surgery: palliative surgery includes two categories: one is not to remove the primary lesion of various short-circuit surgery, the other is to remove the primary lesion of palliative resection. Although the first type is a smaller operation, it generally does not change the natural survival curve of gastric cancer, and can only have the effect of relieving obstruction and alleviating some symptoms. The second type, on the other hand, has a certain 5-year survival rate. According to the data of Beijing Institute of Cancer Prevention and Control, the average survival time of simple dissection cases is (5.31±0.6) months, and palliative short-circuit surgery is (7.66±0.75) months, while the survival rate of 3 and 5 years after palliative resection can be up to 13.21% and 7.09%. Therefore, as long as the systemic condition permits, and there is no extensive distant metastasis, where the local anatomical conditions can still be achieved gastric resection, should strive to remove the primary lesion. Palliative gastrectomy not only eliminates life-threatening complications such as bleeding and perforation of the tumor, but also provides a longer survival period after treatment with medication. (3) Endoscopic mucosal resection: the key to the success of endoscopic tumor resection depends on the early stage of the lesion, the absence of lymphatic metastasis and the ability to completely resect the lesion endoscopically. At present, there is no preoperative method to correctly determine whether the lymph nodes have metastasis or not, so it can only be judged from the knowledge of the lymphatic metastasis pattern of early gastric cancer, combined with the lesions seen under endoscopy. Lymphatic metastasis is generally not found in early gastric cancer in the following cases: ① early gastric cancer with diameter <5mm; ② early gastric cancer with bulging type with diameter <2.5cm; ③ early gastric cancer without ulcerated depression with diameter <2cm; ④ mixed early gastric cancer with diameter <1.5cm; ⑤ early gastric cancer with contraindications to surgery or those who refuse to undergo surgery resolutely. Endoscopic treatment of early gastric cancer includes resection method and non-resection method, the latter includes photosensitive treatment, laser treatment, local injection method and tissue coagulation method. The resection method can obtain the excised mucosal specimen for pathologic examination. In this method, the endoscopic injection needle is first inserted into the stomach through the gastroscopic biopsy hole to reach the edge of the lesion, and saline containing epinephrine is injected into the submucosa, so as to make the local lesion bulge, which is convenient for laparoscopy, and at the same time, it can also isolate the lesion from the muscular layer, protect the muscular layer from the damage caused by electro-coagulation and prevent bleeding. The cut specimen must be pathologically examined, and the absence of cancer cells at the cut end is considered to be complete resection, and the absence of recurrence for 2 years of postoperative follow-up can be classified as a cure. It is generally believed that the complete resection rate of endoscopic mucosal lesions is about 70%. If the resection is incomplete, endoscopic laser treatment can be used to eliminate the residual cancerous foci, and surgery can also be considered. Most of the cases are cured when the lesion disappears after switching to laser treatment. (4) Laparoscopic partial resection: with the development of endoluminal surgery and minimally invasive surgery, laparoscopic total resection of part of the stomach wall has become possible for early gastric cancer. As this operation can be performed without opening the stomach, the whole stomach wall lesion can be removed, and the scope of resection is much wider than endoscopic mucosal resection, and the lymph nodes around the neighboring gastric cancer lesions can be removed together, and if metastasis is found by biopsy, it can be immediately transferred to caesarean section for radical operation. Patients can eat in the early postoperative period, and the hospitalization period is short, so it has its superiority, and the resection scope is wider than that of endoscopy. The operation is generally suitable for lesions in the anterior wall of the stomach, if the lesion is located in the posterior wall or the proximal side, it needs to be resected or surgically removed through the gastric cavity. 2. Chemotherapy The total surgical resection rate of gastric cancer in China is about 50%~77%, and there are still quite a number of cases that have lost the opportunity of surgical resection when they are found. Even in early gastric cancer, 2%~5% of patients have lymph node metastasis, and there are even more patients with microscopic metastasis, and there are still many patients who die of local recurrence and distant organ metastasis after radical resection of gastric cancer. Therefore, chemotherapy is needed for those who lose the opportunity of surgical resection, recurrence and metastasis after surgery and those who develop residual gastric cancer. On the other hand, surgery as a local therapeutic means also has its shortcomings: (1) for patients with advanced stage of disease at the time of surgery, distant metastasis or local lesions with extensive infiltration and involvement of neighboring important organs, the efficacy of surgery alone is not good; (2) it is difficult to detect and deal with potential subclinical metastasis by surgery; (3) the surgical operation itself may contribute to the proliferation and metastasis of the cancer cells. In view of this, in order to improve the efficacy of surgical treatment, it is also necessary to implement comprehensive treatment combined with chemotherapy to make up for the insufficiency of pure surgical treatment. It is estimated that about 2/3 of gastric cancer patients have indications for chemotherapy at different stages of the disease, and it is even suggested that all gastric cancer patients should be supplemented with chemotherapy. For those who are estimated that the tumor cannot be radically resected before operation, preoperative chemotherapy (including arterial cannula interventional chemotherapy) can be considered to reduce the size of primary lesions and metastatic lesions, inhibit the tumor progression, and make surgical resection possible; for those who are found to have liver metastasis or peritoneal metastasis, chemotherapy can be given in the blood vessels supplying the tumor or in the peritoneal cavity; and chemotherapy can be given to those tumor cells invisible to the naked eye left over from the surgery after surgery, so as to prevent the recurrence of the tumor. Postoperatively, chemotherapy will be given to the tumor cells that are invisible to the naked eye after surgery to prevent tumor recurrence. In addition, for preoperative tumor cells that have been planted in the abdominal cavity or seeded in the abdominal cavity during the operation, intraperitoneal chemotherapy and intraperitoneal warm perfusion chemotherapy have been carried out in the clinic; for the characteristics of lymphatic metastasis of tumors, intra-lymphatic chemotherapy is being tried out. In the past decade, the research of gastric cancer chemotherapy has been very active. In addition to the traditional preoperative, intraoperative and postoperative chemotherapy methods, Early postoperative intraperitoneal chemotherapy (EPIC) and Continuous intraperitoneal hyperthermic peritoneal perfusion chemotherapy (Continuous) have been proposed in recent years. EPIC can eradicate tiny cancer foci in the abdominal cavity, prevent intraperitoneal recurrence, and reduce liver metastasis; CHPP can further reduce the recurrence rate and prolong the survival period after radical gastric cancer surgery, and improve the prognosis of patients with advanced gastric cancer with peritoneal implantation metastasis. patients with peritoneal implantation metastasis. Therefore, EPIC and CHPP therapies have been emphasized. (1) Commonly used chemotherapeutic drugs: ① Fluorouracil (5-Fu): since its application in clinic in 1958, it has become the first choice and basic drug for the treatment of gastric cancer both at home and abroad. 5-Fu is a cell-cycle specific drug, which is transformed into 5-fluoro-2′-deoxyuridine monophosphate in vivo, the latter inhibits thymine nucleotide synthetase, prevents the transformation of uracil deoxynucleotide into thymine deoxynucleotide and affects the biosynthesis of cellular DNA, thus influencing the cellular DNA biosynthesis, and thus preventing the development of thymine deoxynucleotide. It affects the biosynthesis of cellular DNA, thus leading to cell damage and death. The total effective rate is about 20%, and the effective period is short, usually averaging 4 to 5 months. The drug can be applied intravenously or taken orally. ② Tegafur (furan fluorouracil): a fluorouracil (5-Fu) derivative synthesized in 1966, which is converted to 5-Fu by cytochrome p-450 microsomal enzyme in liver and soluble enzyme in local tissues in vivo. Due to the low toxicity of the drug, which is 6 times smaller than 5-Fu, the chemotherapeutic index is 2 times of fluorouracil (5-Fu), and the oral and rectal administration of the drug is well absorbed, thus it has become a commonly used drug for the treatment of gastric cancer in recent years. The total effective rate of treating gastric cancer is 31%. (iii) Mitomycin (MMC): It is a cell cycle non-specific drug containing alkylating group which was successfully developed by Japan in 1955 and China in 1965, and its effect is similar to that of alkylating agent, which can cross-link with DNA and depolymerize DNA, thus affecting DNA replication of proliferating cells. The overall effectiveness rate is about 10% to 15%, and the response period is short, averaging about 2 months. The drug is usually administered intravenously in large interstitial doses of 4 to 10 mg per dose, twice weekly. Because of the drug's greater toxic response to the blood system and shorter remission period, it is often used in a combination drug (MFC) regimen. ④Smustine (methylcyclohexylnitrosourea): it is a nitrosourea alkylating agent, a broad-spectrum cell cycle non-specific drug, which has certain efficacy in gastric cancer, with an effective rate of 10%-20%, and an effective period of about 2-3 months. ⑤ Doxorubicin (Adriamycin): it is an anthracycline antitumor antibiotic, which is a cell cycle nonspecific drug, and has been used clinically for more than twenty years, with rapid induction of remission, but the duration is not long, and the total effective rate is 21%~31%. This product has strong toxicity to the heart. (6) Cisplatin (CCDP): as a new type of inorganic anticancer platinum compounds began to be used in clinic in the early 1970's. Studies have shown that this product has synergistic effect with a variety of anticancer drugs and has no obvious cross-resistance, thus it has been widely used in combination chemotherapy. (7) Etoposide (onychomycetin): it is a popular and young variety of more than 40 commonly used chemotherapeutic drugs, belonging to cell cycle-specific drugs, acting at the end of the S phase, the mechanism is to cut off the DNA double strand bound by topoisomerase, and can impede the passage of nucleosides through the plasma membrane, so that they can not enter the nucleus to participate in the replication of DNA. Literature reports that the effective rate of single use for middle and advanced gastric cancer is 21%, and the effective rate of combined chemotherapy can reach 60%~70%, and the complete remission rate can reach 20%. (2) Combination chemotherapy program: the remission rate of single-drug chemotherapy for gastric cancer is only 15%~20%, and the application of combination chemotherapy can improve the remission rate and prolong the survival period. In recent years, the EAP and ELF combination chemotherapy regimen reported not only the remission rate (CR PR) of gastric cancer can reach more than 50%, but also the complete remission rate can reach more than 10%, and the median survival period can be prolonged to 9-18 months, which makes the chemotherapy of gastric cancer have a significant improvement. Various commonly used chemotherapy regimens are listed in Table 5. (3) Route of administration: ① Intravenous drip: it is still the main route of chemotherapy for advanced gastric cancer. However, due to the fact that the anti-cancer drugs are dispersed to the whole body tissues with the blood in intravenous chemotherapy and the local drug concentration in the tumor is limited, the toxic side effects are large and the curative effect is not good. When deciding the chemotherapy plan in clinic, firstly, we should consider the tumor's pathological tissue type, location, disease stage and other factors. Gastric cancer is mostly adenocarcinoma, and fluorouracil (5-Fu), mitomycin (MMC), doxorubicin (Adriamycin), simostigmine (metacyclic nitrosourea) are often used. For early gastric cancer without lymph node metastasis and complete surgical resection, chemotherapy may not be added; advanced gastric cancer adopts chemotherapy as the main treatment or adjuvant chemotherapy after surgery, which usually lasts for 1.5 to 2 years and starts in 3 to 4 weeks after surgery. At present, chemotherapy for gastric cancer mostly adopts combined program, with an effective rate of 40%, among which the efficacy of FAM program is the best (fluorouracil + doxorubicin + mitomycin), and the total amount of one course of treatment is 10g of fluorouracil (5-Fu), 40mg of mitomycin (MMC), and the amount of doxorubicin (ADM) shall not be more than 550mg, which is forbidden to those who have a history of heart failure, and the amount of doxorubicin (ADM) is reduced by half in the case of hepatic function disorder. The dosage of doxorubicin (ADM) should be halved in patients with hepatic dysfunction. Liver and kidney function, electrocardiogram and white blood cell count should be measured during the period of drug administration, if the white blood cell count is lower than 3.5×l09/L and platelet count is lower than 70×109/L, the drug should be suspended.