PURPOSE: Adjuvant 5-fluorouracil-based chemoradiotherapy has been shown to improve the prognosis of gastric cancer. To optimize these results, in the present study oxaliplatin and capecitabine were used instead of 5-fluorouracil. We sought to determine the maximum tolerated dose and the dose-limiting toxicities (DLT) of these drugs in combination with intensity-modulated radiotherapy. METHODS AND MATERIALS: Patients with resected adenocarcinoma of the stomach or the gastroesophageal junction were included. They received two cycles of induction chemotherapy (oxaliplatin and capecitabine [XelOx] regimen). Using standard Phase I methodology, patients received 45 Gy in 1.8-Gy fractions either in combination with capecitabine 825 mg m(-1) twice a day (Dose Level [DL] I) or capecitabine in combination with weekly oxaliplatin 40 or 50 mg m(-1) (DL II and III). After the completion of chemoradiation, two additional cycles of XelOx were scheduled. RESULTS: A total of 32 patients were recruited. Only 1 of 6 patients evaluable on DL I had DLT. Of the first 6 patients on DL II, 1 patient experienced DLT, and 3 of the remaining patients had Grade 3 toxicity. Therefore, DL II was defined as the maximum tolerated dose and a total of 20 patients were treated at this DL. The most frequently observed toxicities (Common Toxicity Criteria Grades 1, 2 and 3) were, respectively, leukocytopenia in 5, 5, and 4 patients; nausea in 3, 7, and 3; and diarrhea in 4, 0, and 1. CONCLUSIONS: In summary, capecitabine 825 mg m(-1) twice a day (Days 1-33) and weekly oxaliplatin 40 mg m(-1) was safe and tolerable in combination with intensity-modulated radiotherapy. Furthermore, four cycles of XelOx could be applied before and after chemoradiotherapy in two thirds of the patients.
PURPOSE: Adjuvant 5-fluorouracil-based chemoradiotherapy has been shown to improve the prognosis of gastric cancer. To optimize these results, in the present study oxaliplatin and capecitabine were used instead of 5-fluorouracil. We sought to determine the maximum tolerated dose and the dose-limiting toxicities (DLT) of these drugs in combination with intensity-modulated radiotherapy. METHODS AND MATERIALS: Patients with resected adenocarcinoma of the stomach or the gastroesophageal junction were included. They received two cycles of induction chemotherapy (oxaliplatin and capecitabine [XelOx] regimen). Using standard Phase I methodology, patients received 45 Gy in 1.8-Gy fractions either in combination with capecitabine 825 mg m(-1) twice a day (Dose Level [DL] I) or capecitabine in combination with weekly oxaliplatin 40 or 50 mg m(-1) (DL II and III). After the completion of chemoradiation, two additional cycles of XelOx were scheduled. RESULTS: A total of 32 patients were recruited. Only 1 of 6 patients evaluable on DL I had DLT. Of the first 6 patients on DL II, 1 patient experienced DLT, and 3 of the remaining patients had Grade 3 toxicity. Therefore, DL II was defined as the maximum tolerated dose and a total of 20 patients were treated at this DL. The most frequently observed toxicities (Common Toxicity Criteria Grades 1, 2 and 3) were, respectively, leukocytopenia in 5, 5, and 4 patients; nausea in 3, 7, and 3; and diarrhea in 4, 0, and 1. CONCLUSIONS: In summary, capecitabine 825 mg m(-1) twice a day (Days 1-33) and weekly oxaliplatin 40 mg m(-1) was safe and tolerable in combination with intensity-modulated radiotherapy. Furthermore, four cycles of XelOx could be applied before and after chemoradiotherapy in two thirds of the patients.
Authors: Stefan Haneder; Johannes Michael Budjan; Stefan Oswald Schoenberg; Simon Konstandin; Lothar Rudi Schad; Ralf Dieter Hofheinz; Veronika Gramlich; Frederik Wenz; Frank Lohr; Judit Boda-Heggemann Journal: Strahlenther Onkol Date: 2014-12-02 Impact factor: 3.621
Authors: J Boda-Heggemann; C Weiss; V Schneider; R-D Hofheinz; S Haneder; H Michaely; H Wertz; U Ronellenfitsch; A Hochhaus; F Wenz; F Lohr Journal: Strahlenther Onkol Date: 2013-04-06 Impact factor: 3.621
Authors: Markus Moehler; Christoph T H Baltin; Matthias Ebert; Wolfgang Fischbach; Ines Gockel; Lars Grenacher; Arnulf H Hölscher; Florian Lordick; Peter Malfertheiner; Helmut Messmann; Hans-Joachim Meyer; Anne Palmqvist; Christoph Röcken; Christoph Schuhmacher; Michael Stahl; Martin Stuschke; Michael Vieth; Christian Wittekind; Dorothea Wagner; Stefan P Mönig Journal: Gastric Cancer Date: 2014-09-07 Impact factor: 7.370
Authors: Daniel Buergy; Frank Lohr; Tobias Baack; Kerstin Siebenlist; Stefan Haneder; Henrik Michaely; Frederik Wenz; Judit Boda-Heggemann Journal: Radiat Oncol Date: 2012-11-16 Impact factor: 3.481