Yahyazadeh-Jabbari Seyyed-Hossein, Malekpour Nasser, Salmanian Bahram, Foodazi Hossein, Salehi Masoud, Noorizadeh Farsad
Clinical Research Center, Milad Hospital, Tehran, Iran ; Dept. of Radiation Oncology, Fayazbakhsh Hospital, Tehran, Iran.
Clinical Research Center, Milad Hospital, Tehran, Iran.
Iran J Cancer Prev. 2013 Summer;6(3):133-40.
Early stage gastric cancer diagnosis has ensued different approaches in resection strategies. In order to increase the proportion of cases which have undergone radical resection or have reduced the recurrence rate, different pre-operative treatments have introduced. Here, we have verified an active preoperative chemotherapeutic regimen in locally advanced gastric cancer patients.
Forty nine patients who have found eligible to enter this phase 2 trial have treated with oxaliplatin 100 mg/m2 IV, docetaxel 50 mg/m2 IV, plus capecitabine 625 mg/m2 PO (TOX). Clinical staging has been following the first 2 cycles of induction chemotherapy. Patients that have further undergone radical surgery, have evaluated for pathological response rate.
Anemia (10.2%), nausea (10.2%) and vomiting (6.1%) were the most frequent grade 3 or 4 adverse effects. Regarding the pathologic staging, 6 patients (12.2%) had complete response (95% CI 3% to 21.4%), 18 of them (36.7%) had partial response (95% CI 23.2% to 50.2%), then 3 patients (6.1%) had stable disease (95% CI 0%-12.8%). Among the patients who had surgery, 22% had pathologic complete response.
Preoperative chemotherapeutic regimen of TOX seems to be an active and safe neoadjuvant therapy in non metastatic gastric cancer. It should further be considered with concurrent radiotherapy.
早期胃癌诊断在切除策略上有不同的方法。为了提高根治性切除病例的比例或降低复发率,引入了不同的术前治疗方法。在此,我们验证了一种针对局部晚期胃癌患者的积极术前化疗方案。
49名被认为符合进入该2期试验条件的患者接受了奥沙利铂100mg/m²静脉注射、多西他赛50mg/m²静脉注射加卡培他滨625mg/m²口服(TOX)治疗。临床分期在诱导化疗的前2个周期后进行。进一步接受根治性手术的患者,评估其病理缓解率。
贫血(10.2%)、恶心(10.2%)和呕吐(6.1%)是最常见的3级或4级不良反应。关于病理分期,6名患者(12.2%)达到完全缓解(95%CI 3%至21.4%),其中18名(36.7%)达到部分缓解(95%CI 23.2%至50.2%),然后3名患者(6.1%)病情稳定(95%CI 0%-12.8%)。在接受手术的患者中,22%达到病理完全缓解。
TOX术前化疗方案似乎是一种针对非转移性胃癌的积极且安全的新辅助治疗方法。应进一步考虑联合放疗。