Effectiveness of neoadjuvant chemotherapy with a docetaxel, cisplatin, and S-1 (DCS) regimen for T4b gastric cancer.
| Title: | Effectiveness of neoadjuvant chemotherapy with a docetaxel, cisplatin, and S-1 (DCS) regimen for T4b gastric cancer. |
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| Authors: | Long VD; Department of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam. long.vd@umc.edu.vn.; Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. long.vd@umc.edu.vn.; Thong DQ; Department of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam.; Dat TQ; Department of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam.; Nguyen DT; Department of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam.; Phuoc TD; Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Hai NV; Department of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam.; Vuong NL; Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Trung LQ; Department of Oncology, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.; Bac NH; Department of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang, Ward 11, District 5, Ho Chi Minh City, Vietnam.; Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. |
| Source: | World journal of surgical oncology [World J Surg Oncol] 2024 Dec 20; Vol. 22 (1), pp. 335. Date of Electronic Publication: 2024 Dec 20. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 101170544 Publication Model: Electronic Cited Medium: Internet ISSN: 1477-7819 (Electronic) Linking ISSN: 14777819 NLM ISO Abbreviation: World J Surg Oncol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central, 2003- |
| MeSH Terms: | Stomach Neoplasms*/pathology ; Stomach Neoplasms*/drug therapy ; Stomach Neoplasms*/surgery ; Stomach Neoplasms*/mortality ; Stomach Neoplasms*/therapy ; Cisplatin*/administration & dosage ; Docetaxel*/administration & dosage ; Oxonic Acid*/administration & dosage ; Tegafur*/administration & dosage ; Neoadjuvant Therapy*/methods ; Neoadjuvant Therapy*/mortality ; Antineoplastic Combined Chemotherapy Protocols*/therapeutic use ; Gastrectomy*/mortality ; Drug Combinations*; Chemotherapy, Adjuvant/methods ; Humans ; Male ; Female ; Middle Aged ; Survival Rate ; Aged ; Follow-Up Studies ; Prognosis ; Adult ; Neoplasm Staging ; Retrospective Studies ; Lymph Node Excision |
| Abstract: | Background: No studies on neoadjuvant chemotherapy for gastric cancer (GC) with T4b stage were reported. This study aimed to assess the effectiveness of neoadjuvant chemotherapy using DCS regimen (docetaxel, cisplatin, and S-1) for GC with T4b stage.; Methods: Forty-three patients diagnosed GC with surgical or clinical T4b stage received three or four preoperative cycles of DCS therapy followed by gastrectomy and lymphadenectomy between Jan-2018 and Dec-2022. Short-tern outcomes including tumor response, completion of neoadjuvant chemotherapy, toxicity and adverse events, rate of treatment-related death, R0 resection, rate of complete adjuvant chemotherapy and short-term surgical results were investigated. The oncologic outcomes comprised 3-year OS and 3-year disease-free survival (DFS).; Results: A total of 43 patients with T4b gastric cancer were included in the analysis. Among them, twenty-five patients underwent gastrectomy and lymphadenectomy. The completion rate of neoadjuvant chemotherapy was 88.4%, including 4 cycles of 51.2% and 3 cycles of 37.2%. The disease-control and clinical response rate were 88.4% and 58.1%, respectively. During preoperative chemotherapy, grade 3/4 neutropenia occurred in 20.9%, anemia in 13.9%, hyponatremia in 4.8%, and vomiting in 2.3%. Pathologic complete response was achieved in 8.0%. After surgery, no patient experienced severe complications (Clavien Dindo > = 3). The R0 resection rate was 72.0% and the rate of complete adjuvant chemotherapy was 83.3%. The 3-year OS and DFS rates were 49% and 38%, respectively.; Conclusions: Neoadjuvant chemotherapy with DCS regimen demonstrated a high tolerance, high tumor response rate, high complete adjuvant chemotherapy rate and satisfactory 3-year survival outcomes. Three- or four-course of preoperative DCS regimen is a promising approach for GC with T4b stage.; (© 2024. The Author(s).) |
| Competing Interests: | Declarations. Competing interests: The authors declare no competing interests. Ethical approval: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by Institutional Review Board, University Medical Center Ho Chi Minh city. Approval to perform research on human subjects in this study was provided by the Institutional Review Board, University Medical Center Ho Chi Minh city (registration number: 37/HDDD-DHYD). |
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| Contributed Indexing: | Keywords: Clinical response rate; DCS regimen; Gastric cancer; Neoadjuvant chemotherapy; T4b stage |
| Substance Nomenclature: | Q20Q21Q62J (Cisplatin); 15H5577CQD (Docetaxel); 5VT6420TIG (Oxonic Acid); 1548R74NSZ (Tegafur); 150863-82-4 (S 1 (combination)); 0 (Drug Combinations) |
| Entry Date(s): | Date Created: 20241220 Date Completed: 20241221 Latest Revision: 20250104 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11662709 |
| DOI: | 10.1186/s12957-024-03620-1 |
| PMID: | 39707403 |
| Database: | MEDLINE |
Journal Article