Application of FLEEOX Preoperative Chemotherapy via Intra-arterial and Intravenous Administration in Treatment of Unresectable Locally Advanced Gastric Cancer

Male Organoplatinum Compounds Remission Induction Leucovorin Middle Aged Prognosis Neoadjuvant Therapy 3. Good health Oxaliplatin Survival Rate 03 medical and health sciences 0302 clinical medicine Injections, Intra-Arterial Chemotherapy, Adjuvant Stomach Neoplasms Antineoplastic Combined Chemotherapy Protocols Humans Female Fluorouracil Infusions, Intravenous Epirubicin Etoposide
DOI: 10.1007/s11605-016-3153-8 Publication Date: 2016-04-25T14:39:36Z
ABSTRACT
The prognosis of unresectable locally advanced gastric cancer is poor. We applied preoperative chemotherapy via intra-arterial and intravenous administration to convert an initially unresectable gastric cancer to a resectable cancer.From January 2005 to December 2010, 105 patients with unresectable locally advanced gastric cancer (T3-4N1-3M0) were selected for preoperative chemotherapy with 5-FU + leucovorin + etoposide + oxaliplatin + epirubicin (FLEEOX) regimen. 5-Fu (370 mg/m(2)) and leucovorin (200 mg/m(2)) were administered by intravenous infusion on days 1-5. Intra-arterial administration of etoposide (80 mg/m(2)), oxaliplatin (80 mg/m(2)), and epirubicin (30 mg/m(2)) was performed by Seldinger method on days 6 and 20, repeated two cycles. Patients who achieved partial response (PR) or complete response (CR) underwent D2 dissection, followed by four to six cycles of XELOX chemotherapy. The response rate, 1- and 3-year survival rate, and R0 resection rate were evaluated.The response rate of preoperative chemotherapy was 78.1 % (82 of 105 patients), with 7 cases of CR and 75 cases of PR, respectively. After chemotherapy, a total of 78 patients (74.3 %) underwent surgery, and 67 cases achieved R0 resection (85.9 %). The 1- and 3-year overall survival (OS) rate of all 105 patients was 71.9 and 31.7 % (median survival time, 18 months). The 1- and 3-year OS rate among the 78 patients treated with chemotherapy plus surgery was 84.5 and 40 % (median survival time, 30 months). Patients treated with chemotherapy plus surgery had significantly longer OS times than patients who underwent chemotherapy alone (P < 0.01).Patients with unresectable gastric cancer may obtain a survival benefit from preoperative chemotherapy via intra-arterial and intravenous administration and subsequent surgery.
SUPPLEMENTAL MATERIAL
Coming soon ....
REFERENCES (19)
CITATIONS (8)