Neoadjuvant chemoradiotherapy followed by laparoscopic distal gastrectomy in advanced gastric cancer: A case report and review of literature

Table 2 Phase III published and ongoing studies of neoadjuvant/preoperative radiation/chemoradiation following curative gastrectomy in gastric cancer (with or without esophagogastric junction)

Ref.	Trial (accrual period)	No pts	Eligibility	Treatment/Design	Surgery	Response rate	Survival	Adverse outcomes
Skoropad et al[32]	(1974-1978)	102	Stomach/EGJ, cM0	20 Gy/5 fractions → S vs S	D1 and beyond	NA	5-yr OS 30% vs 39%, NS; 10-yr OS 32% vs 18%, NS	Complications 57% vs 49%, NS; postoperative death 9.8% vs 11.8%, NS
Leong et al[33]	TOPGEAR (2009-2014)	75	Stomach/EGJ, cTNM IB-IIIC	ECF×2 → 45 Gy/25 fractions + 5-Fu→ S →ECF × 3 vs ECF × 3 → S →ECF × 3	D2, D1+	NA	In progress	No/noncurative surgery, 15% vs 10%, NS; Grade 3-4 AE 52% vs 50%, NS; surgical complications 22% vs 22% NS
https://clinicaltrials.gov/ct2/show/study/NCT01815853	Neo-CRAG (2013-)	620 (estimated)	LAGC, cT3N2/N3M0, cT4aN+M0, cT4bNanyM0	45 Gy/25 fractions → XELOX × 3 → S → XELOX × 3 vs XELOX × 3 → S → XELOX × 3	D2	In progress	In progress	In progress
Liu et al[34]	PREACT (2016-)	682 (estimated)	Stomach/EGJ, LAGC	SOX × 1 → 45 Gy/25 fractions + S-1 → SOX × 1 → S → SOX × 3 vs SOX × 3 → S → SOX × 3	D2 recommended	In progress	In progress	In progress

AE: Adverse events; ECF: Epirubicin/cisplatin/5-Fu; EGJ: Esophagogastric junction; Gy: Grey; LAGC: Locally advanced gastric cancer; NA: Not available; NS: Not significant; OS: Overall survival; S: Surgery; SOX: S-1/Oxaliplatin; XELOX: Capecitabine/Oxaliplatin.