TITLE:
Preoperative Conformal Radiotherapy Concurrently with Paclitaxel/Carboplatin in Gastric Cancer
AUTHORS:
Shimaa Ahmed, Mayada Fawzy, Khalid Rezk, Wessam Elshrif, Mohamed Alaa, Mohamed M. H. Abd Ellah
KEYWORDS:
Gastric Adenocarcinoma, Neoadjuvant, Paclitaxel-Carboplatin, Chemoradiotherapy, Pathologicalcr-R0
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.6,
June
25,
2018
ABSTRACT: Background
and objectives: Surgery is the primary therapy for localized gastric
cancer, but even with the best results only 40% 5-year survival can be achieved
with the use of postoperative adjuvant chemoradiotherapy. Preoperative therapy
might help increase the R0 resection rate, which is an independent predictor of
5-year OS. Our study hypothesized that the concurrent combination of
carboplatin-paclitaxel with radiation therapy would result in a pathological CR
rate, which will be in turn associated with OAS and DFS benefits. Patients
and methods: prospective phase II study included 32 patients with locally
advanced gastric adenocarcinoma including gastroesophageal junction who
received a combination of neoadjuvant conformal radiotherapy concurrently with
carboplatin-paclitaxel followed by surgery. Results: Pathological CR and
R0 resection rates were 18.8% and 75% respectively. With a median follow up of
24 months, 2 years disease-free survival was 28.1% and overall survival was
51.3%. The regimen was tolerated with neither grade 4 toxicities nor deaths. Conclusion: Neoadjuvant radiotherapy concomitant with
carboplatin-paclitaxel chemotherapy is a well-tolerated approach for patients
with locally advanced gastric adenocarcinoma resulting in significant
pathological CR and R0 resection margins as reflected by the good DFS and OS.