Klin Onkol 2002; 15(6): 216-218.
Summary:
Background and Purpose: Unsatisfactory results of surgery alone lead to testing of neoadjuvant therapy aimed to achieve radical resection with microscopically negative margins (RO resection). The aim of Dur study was testing of the tolerance of neoadjuvant regime consisting of 5-fluorouracil, cisplatin and paclitaxel in combination with radiotherapy and its effect on achievement of RO resection.
Patients and Methods: From April1999 to November 2001 16 patients with locally advanced gastric cancer were treated. Neoadjuvant chemoradiotherapy consisted of two 3-week cycles: 5 fluorouracil200 mwm days 121, cisplatin 25 mg/m2 days 1,8 and 15. Paclitaxe160 mg/m2 days 1, 8 and 15 was added in 8 patients. Calclum folinat 45 mg I?er dar was administered in 7 patients. Radiotherapy of stomach and regional nodes 15 x 2 Gy was applicated concolnlttantly with the second course of chemotherapy. Radiotherapy was combined with ultrasound hyperthermia in 5 cases. The surgery was performed during 14 days after the end of chemoradiotherapy.
Results: RO resection was achieved in 12 patients (75%). Neoadjuvant treatment did not increase surgical mortality or morbidity. Neoadjuvant regime was completed in planned extension in 7 patients (43%). In the Test of patients the intensity of chemotherapy has to be reduced due to hematological and gastrointestinal toxicity.
Conclusions: Neoadjuvant chemoradiotherapy can lead to achievement of high rate of RO resections. An optimal regime has to be found in new studies.
