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World J Gastroenterol. Jan 28, 2006; 12(4): 603-607
Published online Jan 28, 2006. doi: 10.3748/wjg.v12.i4.603
Pilot study of postoperative adjuvant chemoradiation for advanced gastric cancer: Adjuvant 5-FU/cisplatin and chemoradiation with capecitabine
Hyung-Sik Lee, Youngmin Choi, Won-Joo Hur, Hyo-Jin Kim, Hyuk-Chan Kwon, Sung-Hyun Kim, Jae-Seok Kim, Jong-Hoon Lee, Ghap-Joong Jung, Min-Chan Kim
Hyung-Sik Lee, Youngmin Choi, Won-Joo Hur, Department of Radiation Oncology, Dong-A University College of Medicine, Busan, South Korea
Hyo-Jin Kim, Hyuk-Chan Kwon, Sung-Hyun Kim, Jae-Seok Kim, Department of Medical Oncology, Dong-A University College of Medicine, Busan, South Korea
Jong-Hoon Lee, Department of Gastroenterology, Dong-A University College of Medicine, Busan, South Korea
Ghap-Joong Jung, Min-Chan Kim, Department of Surgery, Dong-A University College of Medicine, Busan, South Korea
Supported by the Dong-A University Research Fund in 2000
Correspondence to: Dr. Hyung-Sik Lee, Department of Radiation Oncology, Dong-A University Hospital, 3-Ga-1 Dongdaesindong, Seogu, Busan 602-715, South Korea. hyslee@dau.ac.kr
Telephone: +82-51-2405380 Fax: +82-51-2545889
Received: May 31, 2005
Revised: June 28, 2005
Accepted: August 3, 2005
Published online: January 28, 2006
Abstract

AIM: To evaluate the efficacy and toxicity of postoperative chemoradiation using FP chemotherapy and oral capecitabine during radiation for advanced gastric cancer following curative resection.

METHODS: Thirty-one patients who had underwent a potentially curative resection for Stage III and IV (M0) gastric cancer were enrolled. Therapy consists of one cycle of FP (continuous infusion of 5-FU 1000 mg/m2 on d 1 to 5 and cisplatin 60 mg/m2 on d 1) followed by 4500 cGy (180 cGy/d) with capecitabine (1650 mg/m2 daily throughout radiotherapy). Four wk after completion of the radiotherapy, patients received three additional cycles of FP every three wk. The median follow-up duration was 22.2 mo.

RESULTS: The 3-year disease free and overall survival in this study were 82.7% and 83.4%, respectively. Four patients (12.9%) showed relapse during follow-up. Eight patients did not complete all planned adjuvant therapy. Grade 3/4 toxicities included neutropenia in 50.2%, anemia in 12.9%, thrombocytopenia in 3.2% and nausea/vomiting in 3.2%. Neither grade 3/4 hand foot syndrome nor treatment related febrile neutropenia or death were observed.

CONCLUSION: These preliminary results suggest that this postoperative adjuvant chemoradiation regimen of FP before and after capecitabine and concurrent radiotherapy appears well tolerated and offers a comparable toxicity profile to the chemoradiation regimen utilized in INT-0116. This treatment modality allowed successful loco-regional control rate and 3-year overall survival.

Keywords: Gastric cancer; Postoperative; Adjuvant chemotherapy; Chemoradiation