Current adjuvant treatment modalities for gastric cancer: From history to the future

Table 1 Randomized trials of chemotherapy for resected gastric cancer, published after 2000s

Ref.	Regimen	LN (+) % (chemo)	T3-T4 % (chemo)	No. of patients	D2 % (chemo)	% 5-yr survival	P value
Neoadjuvant
Schuhmacher et al[20]	5-FU, LV, cisplatin	94.4	100	72	95.7	72.7	0.2
	Surgery alone			72		69.9
Adjuvant
Bajetta et al[21]	EAP, 5-FU + LV	91	51	137	73	52	0.87
	Surgery alone			137		48
Chipponi et al[22]	5-FU, cisplatin	80	75	101		39.0	NS
	Surgery alone			104		38.7
Bouché et al[23]	5-FU, cisplatin	80.3	77.9	127	55.9	46.6	0.22
	Surgery alone			133		41.9
Sasako et al[24]	S-1	90.4	45.1	529	100	71.7
	Surgery alone			530		61.1
Bang et al[25]	Capecitabine, oxaliplatin	91	45	520	100	83	0.493
	Surgery alone			515		78
Kang et al[26]	MMC + 5’FDR (MF’) vs	90	43	424	100	66.5	0.33
	MF’ + CDDP			431		65
Di Costanzo et al[27]	PELF	83.8	49.2	130	55	47.6	0.41
	Surgery alone			128		48.7
De Vita et al[28]	ELFE	72	80	112	79	48	0.610
	Surgery alone			113		43.5
Nitti et al[29]	FAMTX or FEMTX	82	61	194	88	43	0.86
	Surgery alone			203
Neri et al[30]	EPI, LV, 5-FU	100	84	69		30 m’s (median)	< 0.01
	Surgery alone			68		18
Perioperative
Cunningham et al[31]	EPI, 5-FU, cisplatin	71	56	250	28	36.3	0.009
	Surgery alone			253		23.0
Ychou et al[32]	5-FU, cisplatin	67	58	113	100	38	0.02
	Surgery alone			111		24

5-FU: 5-fluorouracil; EAP: Etoposide, adriamycin, cisplatin; LV: Leucovorin; MMC: Mitomycin C; 5’ FDR: Doksifluridine; EPI: Epirubicine; FAMTX: Fluorouracil, adriamycin; methtrexate; FEMTX: Fluorouracil, epirubicin; methtrexate; PELF: Cisplatin, epirubicin, leucovorin, 5- fluorouracil; ELFE: Epirubicin, leucovorin, 5-fluorouracil, etoposide; CDDP: Cisplatin; LN: Lymph node.

Table 2 Features of major adjuvant chemoradiotherapy trials for gastric cancer

Ref.	CT Regimen without RT/with RT	n (total)	D2 rates	G3-G4 toxicity (hem/GI)	Completeness of treatment	RT technique
Macdonald et al[6]	Bolus 5-FU + LV/bolus 5-FU + LV	556	10%	54%/33%	64%	2D
Lee et al[43]	FP/capecitabine	31	100%	50.2%/12.8%	74.20%	2D
Zhu et al[57]	Bolus 5-FU + LV/bolus 5-FU + LV	380	100%	5.9%/7.5%	NA	IMRT
Leong et al[44]	ECF/inf 5-FU	54	NA	66%/28%	NA	3D
Schwartz et al[49]	PC (PCF arm closed)/PC	78	NA	24%/33% (for PC arm)	NA	3D
Lee et al[4]	XP/capecitabine	458	100%	48.4%/19%	81.7%	3D

CT: Chemotherapy; RT: Radiotherapy; D2: D2 lymph node dissection; G3-G4: Grade 3-grade 4; hem: Hematologic; GI: Gastrointestinal; NA: Not available; 5-FU: 5-fluorouracil; LV: Leucovorin; inf: Infusional; FP: 5-FU, cisplatin; ECF: Epirubicin, cisplatin, 5-FU; PC: Paclitaxel, cisplatin; PCF: Paclitaxel, cisplatin, 5-FU; XP: Capecitabine, cisplatin; 2D: Two-dimensional; 3D: Three-dimensional; IMRT: Intensity modulated radiotherapy.