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Postoperative adjuvant 5-fluorouracil, cisplatin (FP) before and after chemoradiation with capecitabine versus FP alone in completely resected locally advanced gastric cancer



Postoperative adjuvant 5-fluorouracil, cisplatin (FP) before and after chemoradiation with capecitabine versus FP alone in completely resected locally advanced gastric cancer



Journal of Clinical Oncology 23(16_Suppl): 4146-4146



NlmCategory="UNASSIGNED">4146 Background: Gastric cancer is the most common cancer in Korea. Adjuvant chemoradiation has become a standard of care in United States. We attempted to evaluate the efficacy and toxicity of FP before and after postoperative chemoradiation versus FP alone in patients with locally advanced gastric cancer. Patients with gastric cancer staged IIIA to IV-M0 were treated with chemoradiation and FP (arm A) or FP alone (arm B) after curative resection with extensive (D2) lymph node dissection. Arm A consisted of one cycle of FP (5-FU 1000 mg/m2 continuous infusion on day 1-5, cisplatin 60 mg/m2 on day 1) followed by 4,500 cGY (180 cGy/day) to RT field with capecitabine (1,650 mg/m2/day throughout radiation). One month after completion of radiotherapy, patients received three additional cycles of FP every 3 weeks. Arm B consisted of six cycles of FP. Eighty-one patients were enrolled (33;arm A, 48;arm B), and median follow-up duration was 14.7 months (range 1-34.7). A total 9 patients (27.3%) did not complete all planned therapy in arm A, 13 patients (27.1%) in arm B. There was no significant difference in 2-year survival (85.4% vs 78.7%, respectively; P = 0.48), or 2-year disease free survival (69.5% vs. 60.4%, respectively; P = 0.64) between arm A and B. Six patients (18.1%) have relapsed (3; liver, 2; peritoneum, 1; ovary) in arm A, and 11 patients (22.9%) have relapsed (4;liver, 3;peritoneum, 2;bone, 1;ovary, lymph nodes) in arm B. Grade 3/4 neurtopenia occurred in 48.5% in arm A and 22.9% in arm B. Grade 3 nausea/vomiting occurred in 6% in arm A and 14.6% in arm B. There was no grade 3/4 hand foot syndrome, and there has been no treatment related deaths. These preliminary results suggest that postoperative adjuvant chemoradiation and chemotherapy versus chemotherapy alone has similar efficacy in gastric cancer patients who have undergone a D2 dissection. Longer follow up and further studies are needed to evaluate efficacy. No significant financial relationships to disclose.

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Accession: 058582579

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PMID: 27944577


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