scholarly journals Clinical comparison of QOL and adverse events during postoperative adjuvant chemotherapy in outpatients with node-positive colorectal cancer or gastric cancer

2009 ◽  
Vol 21 (4) ◽  
Author(s):  
Mukai
Keyword(s):  
Colorectal Cancer ◽  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Adverse Events ◽  
Postoperative Adjuvant Chemotherapy ◽  
Node Positive ◽  
Clinical Comparison

Neoadjuvant chemoradiotherapy plus postoperative adjuvant XELOX chemotherapy versus postoperative adjuvant chemotherapy with XELOX regimen for local advanced gastric cancer-A randomized, controlled study

2021 ◽  
pp. 20201088
Author(s):  
Fuli Wang ◽  
Aizhong Qu ◽  
Yinping Sun ◽  
Jifeng Zhang ◽  
Benzun Wei ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Postoperative Complications ◽  
Advanced Gastric Cancer ◽  
Neoadjuvant Chemoradiotherapy ◽  
Regional Recurrence ◽  
R0 Resection ◽  
Resection Rate ◽  
Postoperative Adjuvant Chemotherapy ◽  
Local Advanced

Objective: The aim of this study was to compare the clinical efficacy of neoadjuvant chemoradiotherapy (NACRT) combined with postoperative adjuvant XELOX (Oxaliplatin +Capecitabine) chemotherapy and postoperative adjuvant chemotherapy (ACT) with XELOX for local advanced gastric cancer (LAGC). Methods: In this prospectively randomized trial, we investigated the effect of NACRT combined with postoperative ACT for LAGC. 60 patients were randomly divided into NACRT group and ACT group, with 30 patients in each group. Patients in NACRT group were given three-dimensional conformal radiotherapy (45 Gy/1.8 Gy/f) accompanied by synchronous XELOX of two cycles, followed by surgery, and then postoperative adjuvant XELOX chemotherapy of four cycles was performed. Patients in ACT group received surgery in advance, and then XELOX chemotherapy of six cycles was given. Results: The objective response rate of NACRT was 76.7%. The overall incidence of postoperative complications in NACRT group was not significantly different from that in ACT group (23.1% vs 30.0%, p = 0.560). The 1 year, 2 years, and 3 years progression-free survival (PFS）and overall survival (OS) in NACRT and ACT groups were 80.0% vs 56.7%, 73.3% vs 46.7%, 60.0% vs 33.3%, and 86.7% vs 80.0%, 76.7% vs 66.7%, 63.3% vs 50.0%, respectively. Patients in NACRT group showed a significantly higher R0 resection rate (84.6% vs 56.7%, p = 0.029),lower loco-regional recurrence rate (36.7% vs 11.5%, p = 0.039), longer PFS (p = 0.019) and freedom from locoregional progression(FFLP) (p = 0.004) than patients in ACT group, while there was no difference in OS (p = 0.215) and in toxicity incidence (p > 0.05). Conclusions: NACRT combined with postoperative adjuvant XELOX chemotherapy can improve R0 resection rate, reduce loco-regional recurrence, prolong PFS and FFLP without increasing the incidence of postoperative complications in patients with LAGC. Advances in knowledge: Compared with postoperative adjuvant chemotherapy, locally advanced gastric cancer patients may benefit from neoadjuvant chemoradiotherapy, and toxicity associated with chemoradiotherapy was tolerant and manageable.

Phase III Trial to Compare Adjuvant Chemotherapy With Capecitabine and Cisplatin Versus Concurrent Chemoradiotherapy in Gastric Cancer: Final Report of the Adjuvant Chemoradiotherapy in Stomach Tumors Trial, Including Survival and Subset Analyses

2015 ◽  
Vol 33 (28) ◽  
pp. 3130-3136 ◽  
Author(s):  
Se Hoon Park ◽  
Tae Sung Sohn ◽  
Jeeyun Lee ◽  
Do Hoon Lim ◽  
Min Eui Hong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Adjuvant Chemoradiotherapy ◽  
Final Report ◽  
D2 Lymph Node Dissection ◽  
Node Positive ◽  
Stomach Tumors

Purpose The Adjuvant Chemoradiotherapy in Stomach Tumors (ARTIST) trial tested whether the addition of radiotherapy to adjuvant chemotherapy improved disease-free survival (DFS) in patients with D2-resected gastric cancer (GC). Patients and Methods Between November 2004 and April 2008, 458 patients with GC who received gastrectomy with D2 lymph node dissection were randomly assigned to either six cycles of adjuvant chemotherapy with capecitabine and cisplatin (XP) or to two cycles of XP followed by chemoradiotherapy and then two additional cycles of XP (XPRT). This final update contains the first publication of overall survival (OS), together with updated DFS and subset analyses. Results With 7 years of follow-up, DFS remained similar between treatment arms (hazard ratio [HR], 0.740; 95% CI, 0.520 to 1.050; P = .0922). OS also was similar (HR, 1.130; 95% CI, 0.775 to 1.647; P = .5272). The effect of the addition of radiotherapy on DFS and OS differed by Lauren classification (interaction P = .04 for DFS; interaction P = .03 for OS) and lymph node ratio (interaction P < .01 for DFS; interaction P < .01 for OS). Subgroup analyses also showed that chemoradiotherapy significantly improved DFS in patients with node-positive disease and with intestinal-type GC. There was a similar trend for DFS and OS by stage of disease. Conclusion In D2-resected GC, both adjuvant chemotherapy and chemoradiotherapy are tolerated and equally beneficial in preventing relapse. Because results suggest a significant DFS effect of chemoradiotherapy in subsets of patients, the ARTIST 2 trial evaluating adjuvant chemotherapy and chemoradiotherapy in patients with node-positive, D2-resected GC is under way.

Postoperative Adjuvant Chemotherapy for Node-Positive Cervical Adenocarcinoma

2009 ◽  
Vol 19 (2) ◽  
pp. 277-280 ◽  
Author(s):  
Nobuhiro Takeshima ◽  
Kuniko Utsugi ◽  
Katsuhiko Hasumi ◽  
Ken Takizawa
Keyword(s):  
Adjuvant Chemotherapy ◽  
Clinical Stage ◽  
Disease Free Survival ◽  
Pelvic Lymphadenectomy ◽  
Cervical Adenocarcinoma ◽  
Postoperative Chemotherapy ◽  
Postoperative Adjuvant Chemotherapy ◽  
Free Survival ◽  
Node Positive

We examined the effectiveness of postoperative adjuvant chemotherapy for node-positive cervical adenocarcinoma. During the period from 1994 to 2002, 98 consecutive patients with clinical stage I and II cervical adenocarcinoma were treated surgically without having undergone any prior treatment. Surgical procedures included radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. Postoperatively, 21patients were found to have lymph node metastasis, and all were treated with chemotherapy in the absence of radiotherapy. All patients were followed up for at least 5 years. Recurrence developed in 9 of the 21 patients, all 9died of the disease. Six of the 9 recurrences were extrapelvic lesions. Five-year disease-free survival and overall survival were 57% and 67%, respectively. Recurrence was more common in patients with 6 or more positive nodes than in those with fewer than 3 positive nodes. These data suggest the potential role of postoperative chemotherapy for treatments of cervical adenocarcinoma. However, the effectiveness of chemotherapy alone in node-positive cervical adenocarcinoma was likely not as high as that in squamous cell carcinoma. Despite our use of postoperative chemotherapy in the absence of pelvic radiation, the disease recurred predominantly at distant sites.

scholarly journals Efficacy of aspirin for stage III colorectal cancer: a randomized double-blind placebo-controlled trial (JCOG1503C, EPISODE-III trial)

2019 ◽  
Vol 49 (10) ◽  
pp. 985-990 ◽  
Author(s):  
Kenichi Miyamoto ◽  
Atsuo Takashima ◽  
Junki Mizusawa ◽  
Yuya Sato ◽  
Yasuhiro Shimada ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Adverse Events ◽  
Curative Resection ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Stage Iii ◽  
Double Blind ◽  
Free Survival ◽  
Double Blind Placebo

Abstract Adjuvant chemotherapy is the current standard treatment for stage III colorectal cancer after curative resection. However, the prognosis of stage III colorectal cancer is still poor even after curative resection and adjuvant chemotherapy. Several observational studies suggested that the anti-tumor effect of aspirin. Therefore, we planned a randomized double-blind placebo-controlled phase III trial, which commenced in Japan in March 2018, to confirm the superiority of aspirin over placebo added to adjuvant chemotherapy in terms of disease-free survival (DFS) for stage III colorectal cancer patients after curative resection. A total of 880 patients will be accrued from 20 Japanese institutions within 3 years. The primary endpoint is DFS and the secondary endpoints are overall survival, relapse-free survival, relative dose intensity, adverse events, and serious adverse events. This trial has been registered at Japan Registry of Clinical Trials as jRCTs031180009 (https://jrct.niph.go.jp/detail/589).

Postoperative adjuvant chemotherapy with S-1 versus SOX/XELOX regimens for pStage III gastric cancer: A cohort study.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 358-358
Author(s):  
Nobuhiro Tsuchiya ◽  
Chikara Kunisaki
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Adverse Effects ◽  
Therapy Group ◽  
Sensory Neuropathy ◽  
Prognostic Nutritional Index ◽  
Postoperative Adjuvant Chemotherapy ◽  
Curative Gastrectomy ◽  
Nutritional Index ◽  
Peripheral Sensory

358 Background: Adjuvant chemotherapy following curative gastrectomy is recommended for patients with pStage II or III, except pT3 (ss), N0 gastric cancer in Japan. This study aimed to compare the efficacy of postoperative adjuvant chemotherapy with S-1 versus SOX/XELOX for pStageIII gastric cancer. Methods: Between January 2015 and December 2018, 51 patients with pStage III gastric cancer underwent curative gastrectomy. The combination therapy group received a combined SOX and XELOX regimen as follows: (1) SOX regimen: 130 mg/m2 of oxaliplatin on day 1 every 3 weeks combined with 40 mg/m2 of S-1 twice daily on days 1–14 every 3 weeks; (2) XELOX regimen: 130 mg/m2 of oxaliplatin on day 1 every 3 weeks combined with 1000 mg/m2 of capecitabine twice daily on days 1–14 every 3 weeks. We evaluated their hospital records retrospectively. The indication of SOX/XELOX regimens was based on PS and intent of patients. Results: The S-1 group comprised 28 cases (pStage III A/B/C: 12/8/8), while the SOX/XELOX group comprised 23 cases (pStage III A/B/C: 4/10/9). There was no difference in age, sex, comorbidity, prognostic nutritional index and stage between two groups. The 2-year DFS of the S-1 group and the SOX/XELOX group were 58.6% and 71.7%, respectively (p = 0.367). Subgroup analysis showed that the 2-year DFS of patients with pStage IIIC gastric cancer in the S-1 group was significantly lower than the SOX/XELOX group (S-1 vs. SOX/XELOX: 25.9% vs. 78.7%, p = 0.041). As concerns adverse effects (CTCAE ver 4.0), peripheral sensory neuropathy was significantly higher in the SOX/XELOX group than in the S-1 group (S-1: grade I/II 3.6%/0% vs. SOX/XELOX: grade I/II 21.7%/34.8%, p < 0.001), although the other adverse effects did not differ between the two groups. Conclusions: SOX/XELOX therapy may be more useful than S-1 therapy for more advanced tumors among pStage III gastric cancers.

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