Neoadjuvant Chemotherapy with FOLFOX4 Regimen to Treat Advanced Gastric Cancer Improves Survival without Increasing Adverse Events: A Retrospective Cohort Study from a Chinese Center

Abstract

Background/Aim. To evaluate the clinical efficacy of FOLFOX4 (5-fluomumcil/leucovorin combined and oxaliplatin) neoadjuvant chemotherapy for advanced gastric cancer (AGC). Patients and Methods. Fifty-eight AGC patients were enrolled in this retrospective cohort study, 23 in the neoadjuvant group and 35 in the adjuvant group. R0 resection, survival, and adverse events were compared. Results. The two groups were well-matched, with no significant differences in R0 resection rate (82.6% versus 82.0%) and number of lymph nodes dissection (16 (0–49) versus 13 (3–40)) between the two groups (P > 0.05). The number of lymph node metastases in the neoadjuvant group (3 (0–14)) was significantly fewer than that in the adjuvant group (6 (0–27)) (P = 0.04). The neoadjuvant group had significantly better median overall survival (29.0 versus 22.0 months) and 3-year survival rate (73.9% versus 40.0%) than the adjuvant group (P = 0.013). The positive expression rate of Ki-67 in the neoadjuvant group (40.0%, 8/20) was lower than that in the adjuvant group (74.2%, 23/31; P = 0.015). Conclusion. The FOLFOX4 neoadjuvant chemotherapy could improve survival without increasing adverse events in patients with AGC.

Which is better for gastric cancer patients, perioperative or adjuvant chemotherapy: a meta-analysis

“…Nine [ 9 , 17 – 22 , 24 , 25 ] out of eleven studies (5 RCTs and 4 CCTs) evaluated provided effective data for the calculation of the HR for OS. Compared with the AC group, the PC group had significantly better prognosis (HR, 0.74; 95 % CI, 0.61 to 0.89; P < 0.01, Fig.…”

“…Nine [ 9 , 17 – 22 , 24 , 25 ], nine [ 9 , 17 – 22 , 24 , 25 ], seven [ 9 , 17 , 18 , 20 – 22 , 25 ], six [ 9 , 18 , 20 , 21 , 23 , 25 ] studies reported 1-, 2-, 3-, 5- year survival rates, respectively. There were no significant differences in the 1- and 2-year survival rates between the two study groups (1-year survival rate: RR, 0.81; 95 % CI, 0.60 to 1.09; P = 0.17, Additional file 2 A; 2-year survival rate: RR, 0.90; 95 % CI, 0.77 to 1.04; P = 0.15, Additional file 2 B).…”

“…Eight studies [ 9 , 11 , 17 – 20 , 22 , 24 ] reported the response rates to NAC in 358 patients. The response rate ranged between 33.3 and 70.0 %.…”

“…Seven studies [ 9 , 11 , 17 – 19 , 22 , 24 ] reported the radical resection rate. A total of 218 out of 265 patients (82 %) in the PC group and 218 out of 292 (74 %) patients in the AC group received radical resection.…”

Сучасні Методи Комплексного Та Персоніфікованого Лікування Раку Шлунка (Огляд Літератури)

“…Z. Sun з колегами у схожому дослідженні виявили, що проведення НАХТ за схемою FOLFOX 4 (лейковорин, 5-флуороурацил, оксаліплатин) значно підвищує показники виживаності пацієнтів із РШ на ранніх стадіях [20]. Так, у групі НАХТ загальна 3-річна виживаність становила 73,9%, у групі АХТ -40%, медіана загальної виживаності -29 та 22 міс відповідно (р=0,013).…”