Outcomes of preoperative S-1 and docetaxel combination chemotherapy in patients with locally advanced gastric cancer

Autor: Itaru Endo, Kei Sato, Hiroshi Miyamoto, Takashi Kosaka, Sho Sato, Hirotoshi Akiyama, Chikara Kunisaki, Yusaku Tanaka
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
Population
Docetaxel
Toxicology
Gastroenterology
Disease-Free Survival
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Gastrectomy
Stomach Neoplasms
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Pharmacology (medical)
Prospective Studies
Prospective cohort study
education
Aged
Neoplasm Staging
Tegafur
Pharmacology
education.field_of_study
business.industry
Cancer
Combination chemotherapy
Middle Aged
medicine.disease
Neoadjuvant Therapy
Survival Rate
Drug Combinations
Oxonic Acid
Regimen
Treatment Outcome
030104 developmental biology
Oncology
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Female
business
Febrile neutropenia
medicine.drug
Zdroj: Cancer Chemotherapy and Pharmacology. 83:1047-1055
ISSN: 1432-0843
0344-5704
Popis: The therapeutic outcomes of stage III gastric cancer patient receiving D2 gastrectomy and adjuvant chemotherapy remain unsatisfactory. To improve the long-term outcomes in this population, the combination of docetaxel and S-1 (DS) therapy can be expected to be a useful regimen as neoadjuvant chemotherapy (NAC). This study aimed to prospectively evaluate the efficacy of NAC-DS for clinical stage III gastric cancer. Between January 2010 and December 2013, 26 patients were enrolled. Patients with clinical stage III gastric cancer received two courses of docetaxel 40 mg/m2 on day 1, 15 and S-1 40 mg/m2 bid orally on day 1–7, 15–21 every 4 weeks, followed by radical D2 gastrectomy. Short- and long-term outcomes were evaluated. This study was approved by the ethics committee of Yokohama City University, and was registered in the University Hospital Medical Information Network (UMIN) database (ID: 000011521). Of 26 patients, 24 (92.3%) patients completed two courses of NAC. After NAC-DS, Grade 3 neutropenia was observed in 5 (19.2%) patients including one patient with febrile neutropenia, anemia in 1 (3.8%) patient and diarrhea in 1 (3.8%) patient. All patients underwent R0 gastrectomy and pathological response was found in 15 (57.6%) patients. Postoperatively, Clavien-Dindo grade II complication occurred in 8 (30.7%) patients and no mortality was observed. The 5-year overall survival (OS) was 57.7%, median OS was 78.7 months and recurrence free survival (RFS) was 49.0%, median RFS was 45.4 months with 66.5 months median follow-up. Pathological response (HR = 0.091, 95% CI 0.011–0.730, p = 0.016) and > 5% body weight loss before NAC-DS (HR = 0.133, 95% CI 0.023–0.765, p = 0.024) were independent risk factors for recurrence, > 5% body weight loss before NAC-DS (HR = 0.133, 95% CI 0.023–0.765, p = 0.024) were independent risk factors for overall survival by multivariate analysis. NAC-DS demonstrated acceptable toxicity with a high R0 resection rate in clinical stage III gastric cancer patients, especially in patients with good nutritional status. Further prospective study is warranted to compare the long-term outcomes between with and without NAC-DS.
Databáze: OpenAIRE
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