Expression of p53 protein and resistance to preoperative chemotherapy in locally advanced gastric carcinoma

14127 Background: We designed a prospective study to evaluate tolerability, toxicity and effectiveness of concomitant chemoradiotherapy with oral tegafur-uracil (UFT) and leucovorin in locally advanced gastric carcinoma. 13 patients admitted to our center in 10 months of 2003 (March– December) were included. Methods: Only one of the patients was female (7.7%). Median age was 52 (34–72). All of them were operated with negative surgical margins (53.8% of them have undergone total gastrectomy and rest of them were operated subtotally). All of them have 0 and 1 performance status (ECOG). Their tumor were mostly located in antrum (53.8%). 4 (30.8%) of them in stage II and in stage IIIA, IIIB and IV were as follows: 2 (15.4%), 5 (38.5%) and 2 (15.4%). Median lymph node dissection was 14 (7–31). Median time interval between surgery and treatment was 49 days (25–63). All patients were treated 45 Gy (one patient 39.6 Gy and other patient 50.4 Gy) locoregional radiotherapy (RT) and UFT 300 mg/m2/day + leucovorin 90 mg/day in three times a day during RT. Results: All patients tolerated therapy well (RT was interrupted 3 times just in one patient because of grade III emesis). At the end of median two years follow up; recurrence was seen as metastasis in 4 (30.8%) patients and locoregional in 3 (23.1%). 8 patients (61.5%) died (one of them was not related). Median progression free survival was 17 months (6–34) with 53.8% in one year and 38.5% in two years. Median overall survival (OS) was 24 months (8–34), one and two years OS were 76.9% and 46.2%, respectively. Conclusions: Concomitant chemoradiotherapy with orally used agent (UFT and leucovorin) in locally advanced gastric carcinoma is well tolerated regimen. But to increase survival data by continuing therapy with these agent after chemoradiotherapy must be researched. To answer this question another study was conducted and is going on in our center. No significant financial relationships to disclose.

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S-1 plus oxaliplatin compared with fluorouracil/leucovorin/oxaliplatin as neoadjuvant chemotherapy for locally advanced gastric carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.4_suppl.147 ◽

2012 ◽

Vol 30 (4_suppl) ◽

pp. 147-147

Author(s):

Jiren Yu ◽

Yijun Wu ◽

Yuan Gao ◽

Qianyun Shen ◽

Qing Zhang ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Gastric Carcinoma ◽

Clinical Response ◽

Response Rate ◽

Locally Advanced ◽

Preoperative Staging ◽

Complete Response ◽

Clinical Response Rate ◽

R0 Resection ◽

Advanced Gastric Carcinoma

147 Background: Perioperative chemotherapy could improve the prognosis compared with surgery alone. This study is to compare the efficacy and safety of S-1 and oxaliplatin (SOX) with fluorouracil, leucovorin and oxaliplatin (FOLFOX) as neoadjuvant chemotherapy for locally advanced gastric carcinoma. Methods: Patients with histologically confirmed locally advanced gastric carcinoma were enrolled and divided into two groups. Preoperative staging and response evaluation was achieved mainly by gastroscopy and abdominal computer tomography. Neoajuvant chemotherapy consisted of 2-6 cycles of S-1 80mg/m2 (2-week administration and 1-week rest) plus oxaliplatin 130mg/m2 on Day1 in SOX group, or 2 h infusion of 130mg/m2 oxaliplatin plus 2h infusion of 400 mg/m2 leucovorin, followed by infusion of 400 mg/m2 5-fluorouracil on Day 1 and 46 h 2.4 g/m2 bolus in FOLFOX group. The clinical response was evaluated after 2 cycles of chemotherapy, and surgery was attempted. Results: From 2009.9 to 2011.5, 88 patients were enrolled in this study(56 in SOX and 32 in FOLFOX). The clinical response rate was significant higher in the SOX compared with FOLFOX (54.7% vs. 31.2%, p=0.03). 68 patients received surgery(45 in SOX and 23 in FOLFOX), R0 resection rate was similar in both group (SOX: 93.3% vs. FOLFOX: 82.6%, p=0.22). Pathological complete response was observed in 3 patients in SOX group. All enrolled patients were evaluated for the adverse events (AE). The most common non-hematological AE was nausea (57.1% in SOX and 50% in FOLFOX) and vomiting (41.1% in SOX and 40.6% in FOLFOX). The major hematological AE included thrombocytopenia (37.5% in SOX and 21.9% in FOLFOX), neutropenia (33.9% in SOX and 53.1% in FOLFOX) and leukocytopenia (32.1% in SOX and 40.6% in FOLFOX). Conclusions: SOX had higher response rate and acceptable toxicity compared with FOLFOX as neoadjuvant chemotherapy.

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