Leveraging High-Quality Research to Define the Gastric Cancer Landscape in India

Merchant, Shaila J.; Chandramohan, K; Booth, Christopher M.

doi:10.1007/s13193-020-01066-x

Indian J Surg Oncol

2020

DOI: 10.1007/s13193-020-01066-x

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Leveraging High-Quality Research to Define the Gastric Cancer Landscape in India

Shaila J. Merchant

K Chandramohan

Christopher M. Booth

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2021

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Cited by 1 publication

(2 citation statements)

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“…Details on staging, multimodality approach including selective use of radiotherapy (RT) and CT, and surgical methodology are sparse. 7 For medically fit and surgically resectable loco-regionally confined esophagogastric cancer, the National Comprehensive Cancer Network guidelines 8 recommend combined modality treatment consisting of either perioperative chemotherapy (periopCT) or postoperative chemoradiation (poCRT). [9][10][11][12][13] For those who have not received preoperative treatment, after an R0 resection with D2 dissection, CT is recommended; however, when less than a D2 dissection or an R1/R2 resection has been undertaken, poCRT is recommended.…”

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A Pilot Study of Perioperative Cisplatin-Capecitabine Chemotherapy With Preoperative Chemoradiation for Resectable Gastric Cancers

Misra¹,

Yeshala²,

Singh³

et al. 2021

American Journal of Clinical Oncology

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Objectives: The standard of care for resectable gastric cancers (GCs) includes perioperative chemotherapy (CT) or postoperative chemo/ chemoradiotherapy (CRT) strategies. Poor treatment compliance postsurgery suggests that intensified surgical adjuvant treatment is more likely deliverable preceding surgery and, therefore, the safety and efficacy of perioperative cisplatin-capecitabine (CX) with preoperative chemoradiation (preopCRT) were ascertained.Materials and Methods: Between January 2017 and December 2018, 28 potentially resectable locally advanced GC patients were offered neoadjuvant CT-2 cycles of CX at 3-weekly intervals, followed by preopCRT 45 Gy/25 fractions/5 weeks and concurrent capecitabine, followed by surgical resection and 3 adjuvant cycles of CX.Results: Neoadjuvant CT was commenced in 28 patients (100%), preopCRT in 18 patients (64%), and surgery performed in 13 patients (46%). At each treatment step, decreasing patient numbers were due mainly to disease progression (12 [43%]) or other reasons, including (3 [11%]) from treatment-related toxicity. The R0 resection rate was 92% (12/13); a median of 18 nodes was obtained after D2 nodal clearance in 92% (12/13). There were 20%/4%/4% grade 3/4/5 toxicities. The median radiotherapy dose/duration was 45 Gy/5.4 weeks. Adjuvant CT was started in 11 patients (39%) and the third cycle was received by 7 patients (25%). No tumor (ypT0N0) was noted in 23% of the operated patients (3/13), or 11% of the intention-to-treat population (3/28). The median, 1-year, and 2-year survivals were 12 months, 53%, and 32%, respectively.Conclusions: Intensified preoperative treatment is doable in relatively unselected advanced GC patients in real-world settings of a publicsector hospital from a low-middle-income country. Disease progression during preoperative therapy allows patients destined for early clinical evidence of disease dissemination to avoid futile surgery, as opposed to a surgery-first strategy, without an overt increase in surgical morbidity or mortality, with encouraging R0 resection rates.

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“…With respect to treatment of GC in India, little is published. Details on staging, multimodality approach including selective use of radiotherapy (RT) and CT, and surgical methodology are sparse 7…”

mentioning

confidence: 99%

A Pilot Study of Perioperative Cisplatin-Capecitabine Chemotherapy With Preoperative Chemoradiation for Resectable Gastric Cancers

Misra¹,

Yeshala²,

Singh³

et al. 2021

American Journal of Clinical Oncology

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show abstract

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Leveraging High-Quality Research to Define the Gastric Cancer Landscape in India

Cited by 1 publication

References 11 publications

A Pilot Study of Perioperative Cisplatin-Capecitabine Chemotherapy With Preoperative Chemoradiation for Resectable Gastric Cancers

A Pilot Study of Perioperative Cisplatin-Capecitabine Chemotherapy With Preoperative Chemoradiation for Resectable Gastric Cancers

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