Clinical Outcome of Doublet and Triplet Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer.
10.4166/kjg.2016.68.5.245
- Author:
Ju Seok KIM
1
;
Sun Hyung KANG
;
Hee Seok MOON
;
Jae Kyu SUNG
;
Hyun Yong JEONG
;
Ji Young SUL
Author Information
1. Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea. mhs1357@cnuh.co.kr
- Publication Type:Original Article
- Keywords:
Neoadjuvant therapy;
Drug therapy;
Stomach;
Adenocarcinoma
- MeSH:
Adenocarcinoma;
Disease-Free Survival;
Drug Therapy*;
Drug-Related Side Effects and Adverse Reactions;
Humans;
Medical Records;
Neoadjuvant Therapy;
Neoplasm Metastasis;
Recurrence;
Stomach;
Stomach Neoplasms*;
Survival Rate;
Triplets*
- From:The Korean Journal of Gastroenterology
2016;68(5):245-252
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: In gastric cancer, the rate of recurrence and metastasis following radical resection is high, necessitating improvement in survival and cure rates. Neoadjuvant chemotherapy (NAC) has potential benefits for locally advanced gastric cancer; however, the surgical benefits and effects on survival are unclear. This study evaluates the effectiveness of NAC in locally advanced gastric cancer and compares clinical outcomes of doublet and triplet regimens. METHODS: We reviewed patient medical records of 383 patients who underwent NAC (n=41) or surgery only (n=342) for treatment of locally advanced gastric cancer. The baseline characteristics and clinical outcomes were compared between the groups. Chemotherapy patients were classified according to regimen, doublet (n=28) and triplet (n=13), and NAC-related clinical response, safety, and toxicity were analyzed. RESULTS: The baseline characteristics did not differ significantly between groups. After NAC, the tumor downstage rate was 51.2% (21/41); however, overall survival (p=0.205) and disease-free survival (p=0.415) were not significantly different between the groups. On subgroup analysis, no significant differences in drug toxicity (p=0.604) or clinical response (p=0.374) were found between outcomes of doublet and triplet chemotherapy regimens. CONCLUSIONS: In patients with locally advanced gastric cancer, NAC showed tolerable drug toxicity and increased tumor downstage, but NAC failed to increase the survival rate, which may be caused by a high D2-lymphadenectomy rate. Therefore, NAC was found to be a therapeutic option for select gastric cancer patients.
