Korean J Gastroenterol.  2016 Nov;68(5):245-252. 10.4166/kjg.2016.68.5.245.

Clinical Outcome of Doublet and Triplet Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer

• Kim JS
• Kang SH
• Moon HS
• Sung JK
• Jeong HY
• Sul JY

• KMID: 2383501
• DOI: http://doi.org/10.4166/kjg.2016.68.5.245

Abstract

BACKGROUND/AIMS
In gastric cancer, the rate of recurrence and metastasis following radical resection is high, necessitating improvement in survival and cure rates. Neoadjuvant chemotherapy (NAC) has potential benefits for locally advanced gastric cancer; however, the surgical benefits and effects on survival are unclear. This study evaluates the effectiveness of NAC in locally advanced gastric cancer and compares clinical outcomes of doublet and triplet regimens.
METHODS
We reviewed patient medical records of 383 patients who underwent NAC (n=41) or surgery only (n=342) for treatment of locally advanced gastric cancer. The baseline characteristics and clinical outcomes were compared between the groups. Chemotherapy patients were classified according to regimen, doublet (n=28) and triplet (n=13), and NAC-related clinical response, safety, and toxicity were analyzed.
RESULTS
The baseline characteristics did not differ significantly between groups. After NAC, the tumor downstage rate was 51.2% (21/41); however, overall survival (p=0.205) and disease-free survival (p=0.415) were not significantly different between the groups. On subgroup analysis, no significant differences in drug toxicity (p=0.604) or clinical response (p=0.374) were found between outcomes of doublet and triplet chemotherapy regimens.
CONCLUSIONS
In patients with locally advanced gastric cancer, NAC showed tolerable drug toxicity and increased tumor downstage, but NAC failed to increase the survival rate, which may be caused by a high D2-lymphadenectomy rate. Therefore, NAC was found to be a therapeutic option for select gastric cancer patients.

Keyword

Neoadjuvant therapy; Drug therapy; Stomach; Adenocarcinoma

MeSH Terms

Adenocarcinoma
Disease-Free Survival
Drug Therapy*
Drug-Related Side Effects and Adverse Reactions
Humans
Medical Records
Neoadjuvant Therapy
Neoplasm Metastasis
Recurrence
Stomach
Stomach Neoplasms*
Survival Rate
Triplets*

Figure

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  Fig. 1. Kaplan-Meier estimates of overall survival rate.

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  Fig. 2. Kaplan-Meier estimates of disease-free survival rate.

Reference

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