Surgical outcomes in patients with locally advanced gastric cancer treated with S-1 and oxaliplatin as neoadjuvant chemotherapy

Abstract

BackgroundWe wished to evaluate the impact of S-1 combined with oxaliplatin (SOX regimen) as neoadjuvant chemotherapy on surgical outcomes after gastrectomy with D2 lymphadenectomy.MethodsFrom February 2012 to September 2013, 170 patients with American Joint Committee on Cancer (AJCC) stage II–III gastric cancer were assessed retrospectively. Eighty patients underwent neoadjuvant chemotherapy before radical gastrectomy, and 90 patients received surgical treatment with adjuvant chemotherapy. Patients received S-1 (80 mg/m2/day; days 1–14) and oxaliplatin (130 mg/m2; day 1) as neoadjuvant or adjuvant chemotherapy, and this schedule was repeated every 3 weeks. Gastrectomy with D2 lymphadenectomy was standard therapy for each patient. Surgical outcomes between the two groups were analyzed statistically.ResultsThere was no significant difference in the total prevalence of complications between neoadjuvant and adjuvant groups (18.8% vs. 22.2%, P = 0.704). The most common postoperative complications were surgical site infection (6.5%) and gastrointestinal motility disorders (3.5%). The clinical response rate was 68.8%, and ten patients (12.5%) had a pathological complete response after neoadjuvant chemotherapy. The SOX regimen as neoadjuvant chemotherapy for AJCC stage II/III gastric cancer can be effective without increasing the risk of postoperative complications.ConclusionsThe SOX regimen could be a neoadjuvant chemotherapy for advanced gastric cancer worldwide in the future.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-015-0444-6) contains supplementary material, which is available to authorized users.

Effect of apatinib plus neoadjuvant chemotherapy followed by resection on pathologic response in patients with locally advanced gastric adenocarcinoma: A single-arm, open-label, phase II trial

“…The pathologic CR rate was 13.8%, which is higher than the 8% and 8.5% observed in another Chinese trial and a Japanese trial with neoadjuvant SOX [32,33], and similar to the 11% observed in the ST03 trial with epirubicin, cisplatin, capecitabine and bevacizumab [34], the 16% observed in the FLOT-4 trial with current standard therapy of docetaxel, oxaliplatin, leucovorin and fluorouracil [35] and the 13.9% observed in a phase II Chinese trial with preoperative chemoradiation and neoadjuvant SOX [36]. The relatively high preoperative ORR of 79.3% was higher than previous reports [7,33,34,36]. The median tumour shrinkage was 89.7%, also higher than expectation.…”

“…Neoadjuvant chemotherapy may offer benefits for these patients. Combination chemotherapy with S-1 plus oxaliplatin (SOX) for advanced gastric cancer has shown promising efficacy with acceptable toxicity [4e6] and was recommended as neoadjuvant chemotherapy for patients with locally advanced gastric cancer [7,8]. Nevertheless, there are still some patients who cannot benefit from the SOX regimen because of the heterogeneity of their gastric carcinoma or the homogenous insensitivity of tumour to chemotherapy.…”

Morbidity and mortality according to age following gastrectomy for gastric cancer

“…Neoadjuvant chemotherapy obviously does not act as a protective agent, but fitter patients more often receive such therapy. Previous observational and randomized studies showed that neoadjuvant chemotherapy does not result in less morbidity or mortality. In the MAGIC trial, no significant difference was seen in rates of postoperative complication (45·7 versus 45·3 per cent) or mortality (5·6 versus 5·9 per cent) between patients who did or did not receive neoadjuvant chemotherapy.…”

<p>Fullerene Derivatives as Lung Cancer Cell Inhibitors: Investigation of Potential Descriptors Using QSAR Approaches</p>

“…Clinically, chemotherapy is often used to treat the metastatic lung cancer in combination with surgery and radiotherapy. 8,9 However, the efficacy of the existing chemotherapeutics for lung cancer is limited by several drawbacks such as insufficient drug concentrations in tumors, drug resistance of tumor cells, and systemic toxicity. Recent attention has been paid to the development of more selective anticancer agents to treat the cancer and to minimize the side effects.…”