Preoperative Conformal Radiotherapy Concurrently with Paclitaxel/Carboplatin in Gastric Cancer

• 作者: Khalid Rezk Mayada Fawzy Mohamed Alaa Mohamed M. H. Abd Ellah Shimaa Ahmed Wessam Elshrif
• 来源期刊: 癌症治疗(英文)
• 学科: 医学
• 关键词: Gastric Adenocarcinoma NEOADJUVANT Paclitaxel-Carboplatin CHEMORADIOTHERAPY Pathologicalcr-R0
• 年，卷（期）: azzlyw_2018,（6）
• 页码范围: 503-515
• 页数: 13页
• 分类号: R73

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.