OBJECTIVETo investigate the efficacy and safety of S-1 combined with oxaliplatin (SOX regimen) as neoadjuvant chemotherapy for advanced gastric cancer.

METHODSFrom November 2009 to September 2010, 66 patients with advanced gastric cancer were enrolled in this study. Thirty-two patients were given preoperative chemotherapy using SOX regimen. S-1 was administered orally 80 mg·(m(2))(-1)·d(-1) for 14 days, while oxaliplatin(130 mg/m(2)) was administered intravenously on day 1. The treatment was repeated every 3 weeks. The efficacy and safety were assessed every 2 cycles of chemotherapy. The other 34 patients were in control group. R0 resection rate and D2 lymph nodes dissection rate were analyzed for all surgical patients.

RESULTSThe overall response rate of neoadjuvant chemotherapy was 68.8% and disease control rate was 93.8%. Grade 3/4 hematological toxicities were liver dysfunction(9.4%), anemia(6.3%) and neutropenia(6.3%), and non-hematological toxicities included vomiting(12.5%) and anorexia(5.7%). Thirty-two patients after neoadjuvant chemotherapy underwent surgical resection, of whom 25 patients(78.1%) received D2 lymph nodes dissection and the R0 resection rate was 81.3%,higher than those in control group(D2 lymph nodes dissection rate:67.6%,P =0.028; R0 resection rate:73.5%,P =0.040).

CONCLUSIONSOX regimen as neoadjuvant chemotherapy is associated with high efficacy, acceptable adverse effect, and increased rate of D2 lymph nodes dissection and R0 resection.