Preoperative Conformal Radiotherapy Concurrently with Paclitaxel/Carboplatin in Gastric Cancer

作     者：Shimaa Ahmed Mayada Fawzy Khalid Rezk Wessam Elshrif Mohamed Alaa Mohamed M. H. Abd Ellah 

作者机构：Radiation Oncology South Egypt Cancer Institute Assuit University Assiut Egypt Medical Oncology South Egypt Cancer Institute Assuit University Assiut Egypt Surgical Oncology South Egypt Cancer Institute Assuit University Assiut Egypt Clinical Oncology Cairo University Cairo Egypt Clinical Oncology Assuit University Assiut Egypt Diagnostic Radiology South Egypt Cancer Institute Assuit University Assiut Egypt 

出 版 物：《Journal of Cancer Therapy》 (癌症治疗（英文）)

年 卷 期：2018年第9卷第6期

页      面：503-515页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Gastric Adenocarcinoma Neoadjuvant Paclitaxel-Carboplatin Chemoradiotherapy Pathologicalcr-R0 

摘      要：Background and objectives: Surgery is the primary therapy for localized gastric cancer, but even with the best results only 40% 5-year survival can be achieved with the use of postoperative adjuvant chemoradiotherapy. Preoperative therapy might help increase the R0 resection rate, which is an independent predictor of 5-year OS. Our study hypothesized that the concurrent combination of carboplatin-paclitaxel with radiation therapy would result in a pathological CR rate, which will be in turn associated with OAS and DFS benefits. Patients and methods: prospective phase II study included 32 patients with locally advanced gastric adenocarcinoma including gastroesophageal junction who received a combination of neoadjuvant conformal radiotherapy concurrently with carboplatin-paclitaxel followed by surgery. Results: Pathological CR and R0 resection rates were 18.8% and 75% respectively. With a median follow up of 24 months, 2 years disease-free survival was 28.1% and overall survival was 51.3%. The regimen was tolerated with neither grade 4 toxicities nor deaths. Conclusion: Neoadjuvant radiotherapy concomitant with carboplatin-paclitaxel chemotherapy is a well-tolerated approach for patients with locally advanced gastric adenocarcinoma resulting in significant pathological CR and R0 resection margins as reflected by the good DFS and OS.