Hironaga Satake1, Masato Kondo2, Motoko Mizumoto2, Takeshi Kotake3, Yoshihiro Okita4, Takatsugu Ogata3, Yukimasa Hatachi3, Hisateru Yasui3, Akira Miki2, Yukihiro Imai5, Chihiro Ichikawa5, Kenta Murotani6, Masahito Kotaka7, Takeshi Kato8, Satoshi Kaihara2, Akihito Tsuji4. 1. Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe, Japan takeh1977@gmail.com. 2. Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan. 3. Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe, Japan. 4. Department of Clinical Oncology, Kagawa University Hospital, Kita, Japan. 5. Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Japan. 6. Division of Biostatistics, Clinical Research Center, Aichi Medical University, Nagakute, Japan. 7. Gastrointestinal Cancer Center, Sano Hospital, Kobe, Japan. 8. Department of Surgery, Kansai Rosai Hospital, Amagasaki, Japan.
Abstract
AIM: To determine the recommended dose of neoadjuvant chemotherapy of combined capecitabine and oxalipatin (G-XELOX) for locally advanced gastric cancer. PATIENTS AND METHODS: Patients received two cycles of neoadjuvant chemotherapy with oxaliplatin on day 1 and capecitabine (2,000 mg/m2/day, b.i.d.) on days 1-14, repeated every 3 weeks. They then underwent gastrectomy with curative D2/3 lymph-node dissection followed by adjuvant therapy with S-1 for 1 year. De-escalation of oxaliplatin dose was planned (starting at level 1, oxalipatin 130 mg/m2). RESULTS: Six patients were enrolled. The maximum tolerated dose was not reached at level 1. Oxaliplatin at 130 mg/m2 combined with capecitabine at 2,000 mg/m2/day, b.i.d. had acceptable toxicity. No treatment-related death occurred. Most frequent drug-related adverse events during neoadjuvant G-XELOX were nausea and peripheral sensory neuropathy. One patient declined surgical resection, leaving five undergoing resection with curative intent, of whom four achieved pathological down-staging after neoadjuvant G-XELOX. CONCLUSION: Neoadjuvant G-XELOX was feasible in patients with locally advanced gastric cancer. Copyright
AIM: To determine the recommended dose of neoadjuvant chemotherapy of combined capecitabine and oxalipatin (G-XELOX) for locally advanced gastric cancer. PATIENTS AND METHODS: Patients received two cycles of neoadjuvant chemotherapy with oxaliplatin on day 1 and capecitabine (2,000 mg/m2/day, b.i.d.) on days 1-14, repeated every 3 weeks. They then underwent gastrectomy with curative D2/3 lymph-node dissection followed by adjuvant therapy with S-1 for 1 year. De-escalation of oxaliplatin dose was planned (starting at level 1, oxalipatin 130 mg/m2). RESULTS: Six patients were enrolled. The maximum tolerated dose was not reached at level 1. Oxaliplatin at 130 mg/m2 combined with capecitabine at 2,000 mg/m2/day, b.i.d. had acceptable toxicity. No treatment-related death occurred. Most frequent drug-related adverse events during neoadjuvant G-XELOX were nausea and peripheral sensory neuropathy. One patient declined surgical resection, leaving five undergoing resection with curative intent, of whom four achieved pathological down-staging after neoadjuvant G-XELOX. CONCLUSION: Neoadjuvant G-XELOX was feasible in patients with locally advanced gastric cancer. Copyright