Efficacy of neoadjuvant chemotherapy combined with postoperative adjuvant concur-rent radiotherapy and chemotherapy for stageⅢadvanced gastric cancer
10.3969/j.issn.1000-8179.2016.17.389
- VernacularTitle:新辅助化疗联合术后同步放化疗治疗Ⅲ期胃癌的疗效分析
- Author:
Yong CUI
;
Rongxiang ZHANG
;
Fuli WANG
;
Benzun WEI
;
Jiandong ZHANG
- Publication Type:Journal Article
- Keywords:
gastric neoplasm;
neoadjuvant chemotherapy;
radiation therapy;
oxaliplatin;
capecitabine
- From:
Chinese Journal of Clinical Oncology
2016;43(17):747-752
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of neoadjuvant chemotherapy with XELOX (oxaliplatin+capecitabine) regimen combined with postoperative adjuvant concurrent radiotherapy and chemotherapy for stage III advanced gastric cancer. Methods:A total of 55 patients with stage III advanced gastric cancer from Shouguang People's Hospital, Zibo Central Hospital, and Shandong Qian-foshan Hospital of Shandong University were enrolled in this study. The patients were randomly divided into the treatment group and the control group. In the treatment group, 28 patients were treated with neoadjuvant chemotherapy with XELOX regimen, underwent surgery, and then received postoperative adjuvant three-dimensional conformal radiotherapy synchronous XELOX regimen. In the con-trol group, 27 cases underwent surgery in advance, and received radiotherapy synchronous XELOX regimen. Results:The objective re-sponse rate of the treatment group was 75%. The tumor resection rate was 92.9%, which was significantly higher than that of the con-trol group at 81.5%(P=0.049). The tumor radical resection rates in the treatment and control groups were 71.4%and 44.4%, respec-tively, which are significantly different (P=0.043). The lymph node metastasis in the treatment group was 48.2%, which was significant-ly lower than that of the control group at 60.2%(P=0.006). In the treatment group, one case achieved pathologic complete tumor re-gression, 9 cases were of good tumor regression, and 7 cases were of moderate tumor regression. The 1-year, 2-year, and 3-year surviv-al rates of the treatment and control groups were 88.9%vs. 69.2%, 66.7%vs. 46.2%, and 59.3%vs. 38.5%, respectively, which are sig-nificantly different (P=0.037, P=0.045, and P=0.049). The results showed no significant difference of incidence of toxicity in the two groups (P>0.05). Conclusion: Neoadjuvant chemotherapy with XELOX regimen combined with postoperative adjuvant concurrent chemoradiotherapy for stage III advanced gastric cancer can improve the radical resection rate and long-term postoperative survival rate of patients, as well as reduce the rate of lymph node metastasis.
