Clinical study on neoadjuvant chemoradiotherapy with S-1 and cisplatin for locally advanced gastric carcinoma

Abstract

Objective To investigate the efficacy and safety of neoadjuvant chemoradiotherapy with S-1 and cisplatin in locally advanced gastric carcinoma patients. Methods From January 2009 to June 2012, a total of 62 gastric carcinoma patients were enrolled. The chemotherapy regimen consisted of two cycle of S-1 (60 mg/m2, oral administration on day 1st-14th) and cisplatin (60 mg/m2, intravenous infusion on day 1st). Radiotherapy was also performed with a total dose of 45 Gy delivered at 1.8 Gy/fraction, 5 fractions per week. Radical surgery was performed 3 weeks after chemoradiotherapy. Results All 62 patients completed the neoadjuvant radiotherapy, and 57 patients among them completed the neoadjuvant chemotherapy. 57 patients underwent surgery. Neoadjuvant chemoradiotherapy led to a clinical response rate of 69.4% (43/62), and side effects were mostly grade Ⅰ or Ⅱ. The resection rate and radical resection (R0 resection) rate were 93.0% (53/57) and 82.5% (47/57), respectively, and the pathological response rate and pCR rate were 82.5% (47/57) and 8.8% (5/57), respectively. There was no postoperative death, besides, the postoperative complication rate was 15.8% (9/57). The 1-, 2-, and 3-year overall survival rates were 80.7% (46/57), 63.2% (36/57) and 45.6% (26/57), local and regional recurrence-free survival rates were 82.5% (47/57), 66.7% (38/57) and 50.9% (29/57), and distant metastasis-free survival rates were 86.0% (49/57), 68.4% (39/57) and 59.6% (34/57), respectively. Conclusion The neoadjuvant chemoradiotherapy with S-1 and cisplatin combined with intensity modulated radiotherapy have a favorable effect for the treatment of locally advanced gastric carcinoma, which can promote the R0 resection rate and prolong the survival time with low postoperative complications. Key words: Stomach neoplasms; Neoadjuvant therapy; S-1; Side effect; Prognosis