- The Second Department of General Surgery, The Second Affiliated Hospital of Northern Sichuan Medical College, Mianyang 621000, Sichuan Province, China;
Objective To summarize the current value of neoadjuvant chemotherapy (NAC) for potentially resectable gastric cancer.
Methods The recent 5-year literatures searched through the PubMed with the key words: stomach neoplasm, gastric cancer/carcinoma, neoadjuvant therapy/chemotherapy and preoperative therapy/chemotherapy as well as the relevant reports presented in the ASCO Annual Meeting in 2007 and 2008 were analyzed. The present status of NAC for advanced gastric cancer was summarized, the necessity and feasibility were evaluated, and the patients features for selecting, the predictors for response, the mainly existing problems and development trend of NAC were analyzed.
Results At present, there were 7 randomized control trails (RCT) published, and among them 3 were phase Ⅲ. It was safe, effective and feasible to most of trails in NAC for gastric cancer. However, it was still little to obtain survival benefit for NAC RCT, and short of randomized trial comparing strict preoperative chemotherapy to surgery alone or perioperative chemotherapy to surgery plus adjuvant chemotherapy. It remained lots of problems such as how to select the appropriate patients, the effective induced regimes and the predicted factors, the evaluated indices for response.
Conclusion NAC is a safe, feasible and efficient method to potentially resectable gastric cancer, but strict phase Ⅲ randomized trials are needed. In the future, substantial improvements of treatment outcome will likely depend on the novel drugs and molecular biological targeted therapies.
Citation: XIAO Shiming,WU Chen,JIANG Huaiwu. Neoadjuvant Chemotherapy for Potentially Resectable Gastric Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(8): 680-685. doi: Copy
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- 14. 季加孚. 胃癌外科的现状与发展趋势 [J]. 中国普外基础与临床杂志, 2006; 13(1): 1-3.
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- 37. Fujitani K, Sasako M, Iwasaki Y, et al. A phase Ⅱ study of preoperative chemotherapy (CX) with S-1 and cisplatin followed by gastrectomy for clinically resectable type 4 and large type 3 gastric cancer: JCOG 0210[J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): 4609.
- 38. Imamura H, IIishi H, Tsuburaya A, et al. Randomized ph-ase Ⅲ study of irinotecan plus S-1 (IRIS) versus S-1 alone as first-line treatment for advanced gastric cancer (GC0301/TOP-002)[A/OL]. 2008 Gastrointestinal Cancers Symposium: Abstract 5.
- 39. Boku N, Yamamoto S, Shirao K. Randomized phase Ⅲ study of 5-fluorouracil (5-FU) alone versus combination of irinotecan and cisplatin (CP) versus S-1 alone in advanced gastric cancer (JCOG9912) [J]. J Clin Oncol (Meeting Abstracts), 2007; 25(18S): LBA4513.
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