Neoadjuvant Chemotherapy for Advanced Gastric Carcinoma with Non-Curative Clinical Factors.

Nashimoto, Atsushi; Sasaki, Juei; Tanaka, Otsuo; Tsutsui, Mitsuhiro; Tsuchiya, Y.; Makino, Haruhiko

doi:10.5833/jjgs.31.2199

Cited by 6 publications

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“…Detection of systemic metastases in patients while they were receiving chemotherapy, or peritoneal dissemination detected on laparotomy were the main reasons for not performing a resection. In Japan, the rate of postoperative complications was not increased to the rate observed in patients who had primary resection [18,31]. We experienced a high incidence of toxicity with FP, but its grade was moderate and controllable by symptomatic measures.…”

Section: Discussionmentioning

confidence: 86%

Neoadjuvant chemotherapy in advanced gastric cancer with non-curative factors: a Phase II study with 5-fluorouracil, leucovorin, and cisplatin

et al. 1999

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BACKGROUND: Neoadjuvant chemotherapy (NAC) has recently received increasing attention in an attempt to increase the rate of complete tumor resections, reduce systemic metastases, and prolong survival in patients with advanced gastric cancer.METHODS: Since 1993, 21 patients with unresectable or non-curative resectable gastric cancer received NAC, consisting of 5-fluorouracil, leucovorin, and cisplatin (FLP) with at least two cycles before surgery.RESULTS: All except 2 patients underwent surgical treatment, and resection was performed in 18 (85.7%). There were no deaths and no major morbidity following operation. There was no complete response (CR), but 12 patients (57.1%) had a partial response (PR), the response rate was 47.6% for the primary region, 64.7% for abdominal para-aortic (No.16) lymph node metastasis, 40.0% for liver metastasis, and 11.1% for peritoneal dissemination. One-year survival of the 21 patients was 40.5%, and median survival time (MST) was 322 days. MST in the responders was 571 days, and that in non-responders was 199 days ( P < 0.01). MST was 835 days in patients who underwent curative resection and 310 days in those who underwent non-curative surgery ( P < 0.01). There was no grade 4 toxicity, but grade 3 leukopenia occurred in 4 patients (19.0%), grade 3 anemia occurred in 3 patients (14.3%), and grade 3 stomatitis in 2 patients (9.5%). There were no serious renal disorders and no treatment-related death.CONCLUSIONS: The combination of FLP for NAC was feasible and useful for tumor reduction, especially for No.16 lymph node metastasis. There was a survival benefit in patients whose tumor had PR or who had had curative resection. We should confirm the effect and survival benefit of FLP for NAC by a prospectively randomized clinical controlled study.

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Section: Discussionmentioning

confidence: 86%