Md Sener Cihan, Md Suzan Onol, Md Selma Sengiz Erhan
Department of Medical Oncology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, 34384, Istanbul, Turkey.
Department of Radiology, University of Health Sciences, Prof. Dr. Cemil Tascioglu City Hospital, 34384, Istanbul, Turkey.
J Cancer. 2022 Feb 28;13(5):1449-1455. doi: 10.7150/jca.67734. eCollection 2022.
We aimed to investigate whether Computed Tomography (CT) attenuation change is predictive of poor pathological response in patients with gastric cancer (GC) and gastroesophageal junction (GEJ) adenocarcinoma who received perioperative fluorouracil (FU), leucovorin (LV), oxaliplatin, and docetaxel (FLOT) regimen. This trial was planned as a retrospective single-center study. In the neoadjuvant setting, patients received a regimen that includes docetaxel (50 mg/m), oxaliplatin (85 mg/m), and LV (200 mg/m) with short-term infusional FU (2600 mg/m as a 24-hour infusion), on day 1 and administered every two weeks for four cycles. Patients were classified as response rates according to the CAP-TRG system (0-1 response or 2-3 response) after completing four cycles of the FLOT regimen. In total, 108 patients with GC and GEJ adenocarcinoma were included in the study. In a univariate analysis, age, histologic grade, T stage, N stage, and change in attenuation were found to be the statistically significant factors (p = 0.034, p =0.038, p = 0.001, p =0.029, and p = 0.022, respectively). In a multivariate analysis, T4 tumors and a higher change in attenuation were found to be important factors associated with poor pathologic response (p = 0.027 and p = 0.038, respectively). Our results demonstrate that a higher decrease in CT attenuation and T4 tumors is associated with a poor response to perioperative FLOT chemotherapy in patients with GC and GEJ adenocarcinoma.
我们旨在研究计算机断层扫描（CT）衰减变化是否可预测接受围手术期氟尿嘧啶（FU）、亚叶酸钙（LV）、奥沙利铂和多西他赛（FLOT）方案治疗的胃癌（GC）和胃食管交界（GEJ）腺癌患者的病理反应不佳情况。本试验计划为一项回顾性单中心研究。在新辅助治疗中，患者在第1天接受包含多西他赛（50mg/m²）、奥沙利铂（85mg/m²）和LV（200mg/m²）以及短期输注FU（2600mg/m²作为24小时输注）的方案，每两周给药一次，共四个周期。在完成四个周期的FLOT方案后，根据CAP - TRG系统将患者分类为反应率（0 - 1反应或2 - 3反应）。本研究共纳入108例GC和GEJ腺癌患者。在单因素分析中，年龄、组织学分级、T分期、N分期和衰减变化被发现是具有统计学意义的因素（分别为p = 0.034、p = 0.038、p = 0.001、p = 0.029和p = 0.022）。在多因素分析中，T4期肿瘤和更高的衰减变化被发现是与病理反应不佳相关的重要因素（分别为p = 0.027和p = 0.038）。我们的结果表明，CT衰减的更高降低和T4期肿瘤与GC和GEJ腺癌患者围手术期FLOT化疗反应不佳相关。
