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Docetaxel-Based Preoperative Chemoradiation in Localized Gastric Cancer: Impact of Pathological Complete Response on Patient Outcome

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Abstract

Purpose

This study was conducted to evaluate the feasibility, efficacy, and toxicities of docetaxel-based induction chemotherapy and chemoradiotherapy in patients with localized gastric or gastroesophageal adenocarcinoma.

Methods

Patients with localized, operable gastric or gastroesophageal adenocarcinoma received two cycles of induction chemotherapy of fluorouracil, docetaxel, and cisplatin (TPF) followed by 45 Gy of radiation and concurrent fluorouracil plus docetaxel then surgery for nonmetastatic patients.

Results

Forty-one patients were included. Pretreatment T3 was encountered in 56 % of patients while 61 % had N1 disease. A pathologic complete response (CR) was noted in 24 % of patients. Pathologic response was significantly associated with baseline T stage (P < 0.001) and N stage (P = 0.002). The 3-year overall survival (OS) and disease-free survival were 47.3 and 42.1 %, respectively. OS was significantly correlated with R0 resection (P = 0.027), pathological response (P = 0.01), dissected pathologically positive lymph node (P = 0.037), and postsurgery (T) stage (P = 0.02). Toxicities were manageable and there were no treatment-related deaths.

Conclusion

Docetaxel-based chemoradiotherapy in localized gastric adenocarcinoma patients resulted in 24 % path CR and was not associated with a higher percentage of postoperative complications. A well-designed randomized controlled trial is mandatory to further endorse this evolving approach.

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Conflict of interest

All authors confirm that they did not receive any funds nor financial support from the Faculty of Medicine Alexandria University, Egypt or any other companies. Moreover, all authors affirm that they have no conflicts of interest concerning this study.

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Authors and Affiliations

  1. Clinical Oncology Department, Faculty of Medicine, Alexandria University, Champlion Street, Alazarita, Alexandria, 21131, Egypt

    Y. Rostom, H. Zaghloul & G. Khedr

  2. Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    W. El-Shazly

  3. Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    D. Abd-Allah

Authors
  1. Y. Rostom
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  2. H. Zaghloul
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  3. G. Khedr
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  4. W. El-Shazly
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  5. D. Abd-Allah
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Corresponding author

Correspondence to H. Zaghloul.

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Rostom, Y., Zaghloul, H., Khedr, G. et al. Docetaxel-Based Preoperative Chemoradiation in Localized Gastric Cancer: Impact of Pathological Complete Response on Patient Outcome. J Gastrointest Canc 44, 162–169 (2013). https://doi.org/10.1007/s12029-012-9449-3

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  • DOI: https://doi.org/10.1007/s12029-012-9449-3

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