We evaluated 21 patients with advanced gastric cancer who underwent S-1+CDDP combined neoadjuvant chemotherapy. Methods : Patients with T3-4 gastric cancer with lymph node metastasis or scirrhous gastric cancer received two course of S-1 (80 mg/m 2 daily for 3 weeks) and CDDP (60 mg/m 2 on day 8) combined chemotherapy and then underwent D2 gastrectomy. Results : The ratio of the patients who completed two course of chemotherapy was 85.7%. The response rate was 52.4% and median survival time was 988 days. Toxicity was acceptable with some grade 3 (19%) events. Histopathological effect grading of resected tumor were grade 0/1a/ 1b/2 : 4/ 10/2/5, respectively. We did not use S-1 for postoperative adjuvant chemotherapy who classified grade 0. Conclusion : Combination of S-1+CDDP for neoadjuvant chemotherapy appears to be an effective and feasible for patients with advanced gastric cancer. Histopathological effect grading was useful to decide chemotherapy regimen after operation.
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