Department of Surgery, University of California San Diego, San Diego, California, USA.
Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, USA.
J Surg Oncol. 2021 May;123(8):1716-1723. doi: 10.1002/jso.26458. Epub 2021 Mar 18.
Perioperative therapy is the standard-of-care for locally-advanced gastric cancer but many patients do not respond. There are currently no known factors that predict response to therapy.
This was a retrospective study aimed to evaluate treatment effect grade (TEG) in patients with locally advanced gastric cancer treated with neoadjuvant therapy and surgery at a single center. Ordinal logistic regression was performed to identify predictors of TEG, scaled from 0 to 3.
Fifty patients were identified. The majority were male (n = 33) and 50% were Hispanic. The most common regimens given were: 5-fluorouracil/leucovorin, oxaliplatin, and docetaxel (n = 23, 46%), epirubicin, cis- or oxaliplatin, and 5-fluorouracil/leucovorin or Xeloda (n = 8, 16%), and 5-fluorouracil/leucovorin and oxaliplatin (n = 9, 18%). Twenty-seven patients (55%) had complete or partial response to therapy (TEG 0-2), and 23 patients (46%) had no response (TEG 3). Of numerous variables analyzed, only race and SRC histology were associated with TEG. TEG was associated with disease free, but not disease specific survival.
In this cohort, 46% of patients had no histologic response to therapy. SRC histology, and possibly race, should be considered in determination of optimal multidisciplinary regimens and in amount of therapy to be given upfront, as patients with SRC histology and those of non-Asian race are less likely to respond to standard regimens.
围手术期治疗是局部晚期胃癌的标准治疗方法，但许多患者没有反应。目前尚不知道有哪些已知的因素可以预测对治疗的反应。
这是一项回顾性研究，旨在评估单中心接受新辅助治疗和手术的局部晚期胃癌患者的治疗效果分级（TEG）。采用有序逻辑回归来确定 TEG 的预测因素，范围从 0 到 3。
共确定了 50 名患者。大多数为男性（n=33），50%为西班牙裔。最常见的治疗方案是：5-氟尿嘧啶/亚叶酸、奥沙利铂和多西他赛（n=23，46%）、表柔比星、顺铂或奥沙利铂和 5-氟尿嘧啶/亚叶酸或 Xeloda（n=8，16%）以及 5-氟尿嘧啶/亚叶酸和奥沙利铂（n=9，18%）。27 名患者（55%）对治疗有完全或部分反应（TEG0-2），23 名患者（46%）无反应（TEG3）。在分析的众多变量中，只有种族和 SRC 组织学与 TEG 相关。TEG 与无病生存相关，但与疾病特异性生存无关。
在本队列中，46%的患者对治疗没有组织学反应。SRC 组织学，可能还有种族，应在确定最佳多学科治疗方案和给予初始治疗的量时加以考虑，因为具有 SRC 组织学和非亚洲种族的患者对标准方案的反应性较低。
