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Phase II trial of preoperative sequential chemotherapy followed by chemoradiotherapy for high-risk gastric cancer

 Hyo Song Kim  ;  Woong Sub Koom  ;  Song-Ee Baek  ;  Hyoung-Il Kim  ;  Minkyu Jung  ;  Seung-Hoon Beom  ;  Beodeul Kang  ;  Hyunki Kim  ;  Jee Suk Chang  ;  Yoon Young Choi  ;  Taeil Son  ;  Jae-Ho Cheong  ;  Sung Hoon Noh  ;  Eun Hye Kim  ;  Jun Chul Park  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee  ;  Su-Jin Shin  ;  Hyunsoo Chung  ;  Inkyung Jung  ;  Hyun Cheol Chung  ;  Joon Seok Lim  ;  Woo Jin Hyung  ;  Sun Young Rha 
 RADIOTHERAPY AND ONCOLOGY, Vol.140 : 143-149, 2019 
Journal Title
Issue Date
Gastric cancer ; Preoperative chemoradiotherapy ; Preoperative chemotherapy
BACKGROUND AND PURPOSE: To evaluate the safety and efficacy of preoperative chemotherapy (CTx) followed by chemoradiotherapy (CCRT) for high-risk gastric cancer (GC).

METHODS AND MATERIALS: The inclusion criteria were as follows: (1) Borrmann type 4; (2) large Borrmann type 3 (≥8 cm); (3) single bulky (≥3 cm × 1) or multiple lymph nodes (≥1.5 cm × 3). Patients received two 21-day courses of induction CTx of TS-1 (35 mg/m2, p.o, twice daily on days 1-14), docetaxel (30 mg/m2, i.v., days 1 and 8), and cisplatin (30 mg/m2, i.v., days 1 and 8) followed by CCRT (two courses of TS-1 and cisplatin in combination with 45 Gy radiation).

RESULTS: Forty-two patients were enrolled between March 2014 and February 2016, and 39 of these completed sequential CTx and CCRT. Among the 33 patients who underwent R0 resection, the pathologic response rate was 39.4% [no residual carcinoma (n = 5, 15.2%), with 1-10% residual carcinoma (n = 8, 24.2%)]. Overall, 4 patients (12.1%) were pathologic stage 0, 7 (21.2%) were stage I, 10 (30.3%) were stage II, and 12 (36.4%) were stage III. The overall survival rate at 3 years was 77.9% for stages 0 and I, 66.8% for stages II-III, and 33.3% for unresectable cases (P = 0.001). Toxicity was mild to moderate with grade 4 neutropenia (n = 1) and neutropenic fever (n = 1) as the most prominent side-effects.

CONCLUSIONS: Sequential CTx and CCRT prior to surgery are feasible and effective for high-risk GC.

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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Beodeul(강버들) ORCID logo https://orcid.org/0000-0001-5177-8937
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Eun Hye(김은혜) ORCID logo https://orcid.org/0000-0001-6691-6837
Kim, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Kim, Hyo Song(김효송) ORCID logo https://orcid.org/0000-0002-0625-9828
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Beom, Seung Hoon(범승훈) ORCID logo https://orcid.org/0000-0001-7036-3753
Son, Tae Il(손태일) ORCID logo https://orcid.org/0000-0002-0327-5224
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Jung, Min Kyu(정민규) ORCID logo https://orcid.org/0000-0001-8281-3387
Jung, Inkyung(정인경) ORCID logo https://orcid.org/0000-0003-3780-3213
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Chung, Hyun Soo(정현수)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Choi, Yoon Young(최윤영) ORCID logo https://orcid.org/0000-0002-2179-7851
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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