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Feasibility of neoadjuvant S-1 and oxaliplatin followed by surgery for resectable advanced gastric adenocarcinoma

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Abstract

Purpose

In Japan, the administration of S-1 following D2 gastrectomy is a standard treatment for stage II/III gastric cancer (GC). However, the survival of stage IIIB/IIIC GC remains unsatisfactory. To improve this, we conducted a multicenter phase II study to evaluate the safety and efficacy of a neoadjuvant S-1 and oxaliplatin regimen (SOX) followed by surgery targeted at stage III GC.

Methods

Oxaliplatin was administered intravenously (130 mg/m2) on day 1, and S-1 was administered orally (40 mg/m2, twice a day) for 14 days followed by a seven-day rest period. After three cycles of therapy, D2 gastrectomy was performed.

Results

A total of 14 patients were enrolled and completed the protocol treatment. Grade 3/4 toxicities included thrombocytopenia (21.4 %), anorexia (14.3 %), and diarrhea (7.1 %). Seven patients (50 %) underwent total gastrectomy, and seven patients underwent distal gastrectomy. Grade 3/4 surgical complications included pancreatic fistula (21.4 %) and lung infection (7.1 %). The pathological response rate was 85.7 %.

Conclusion

Although our data are limited and preliminary, neoadjuvant SOX followed by surgery can be performed safely with a high pathological response rate in patients with resectable advanced GC. Further investigation of this neoadjuvant approach is warranted.

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Acknowledgments

We thank Mr. Yushi Nagai, Ms. Michiyo Tada, and Ms. Emiko Usami for their assistance with data management. This study was supported by the National Cancer Center Research and Development Fund (Grant no. 23-A-2). Oxaliplatin was provided by Yakult Honsha Co., Ltd. Y.Y. received lecture fees from Taiho.

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Authors and Affiliations

  1. Gastrointestinal Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Yoshitaka Honma, Yasuhide Yamada, Tetsuji Terazawa, Atsuo Takashima, Satoru Iwasa, Ken Kato, Tetsuya Hamaguchi & Yasuhiro Shimada

  2. Gastric Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Masaki Ohashi, Shinji Morita, Takeo Fukagawa & Hitoshi Katai

  3. Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Nozomu Machida

Authors
  1. Yoshitaka Honma
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  2. Yasuhide Yamada
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  3. Tetsuji Terazawa
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Correspondence to Hitoshi Katai.

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Honma, Y., Yamada, Y., Terazawa, T. et al. Feasibility of neoadjuvant S-1 and oxaliplatin followed by surgery for resectable advanced gastric adenocarcinoma. Surg Today 46, 1076–1082 (2016). https://doi.org/10.1007/s00595-015-1276-2

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  • DOI: https://doi.org/10.1007/s00595-015-1276-2

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