Phase II trial of preoperative sequential chemotherapy followed by chemoradiotherapy for high-risk gastric cancer

Hyo Song Kim, Woong Sub Koom, Song Ee Baek, Hyoung Il Kim, Minkyu Jung, Seung Hoon Beom, Beodeul Kang, Hyunki Kim, Jee Suk Chang, Yoon Young Choi, Taeil Son, Jae Ho Cheong, Sung Hoon Noh, Eun Hye Kim, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee, Su Jin Shin, Hyunsoo Chung & 5 others Inkyung Jung, Hyun Cheol Chung, Joon Seok Lim, Woo Jin Hyung, Sun Young Rha

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background and purpose: To evaluate the safety and efficacy of preoperative chemotherapy (CTx) followed by chemoradiotherapy (CCRT) for high-risk gastric cancer (GC). Methods and materials: The inclusion criteria were as follows: (1) Borrmann type 4; (2) large Borrmann type 3 (≥8 cm); (3) single bulky (≥3 cm × 1) or multiple lymph nodes (≥1.5 cm × 3). Patients received two 21-day courses of induction CTx of TS-1 (35 mg/m2, p.o, twice daily on days 1–14), docetaxel (30 mg/m2, i.v., days 1 and 8), and cisplatin (30 mg/m2, i.v., days 1 and 8) followed by CCRT (two courses of TS-1 and cisplatin in combination with 45 Gy radiation). Results: Forty-two patients were enrolled between March 2014 and February 2016, and 39 of these completed sequential CTx and CCRT. Among the 33 patients who underwent R0 resection, the pathologic response rate was 39.4% [no residual carcinoma (n = 5, 15.2%), with 1–10% residual carcinoma (n = 8, 24.2%)]. Overall, 4 patients (12.1%) were pathologic stage 0, 7 (21.2%) were stage I, 10 (30.3%) were stage II, and 12 (36.4%) were stage III. The overall survival rate at 3 years was 77.9% for stages 0 and I, 66.8% for stages II–III, and 33.3% for unresectable cases (P = 0.001). Toxicity was mild to moderate with grade 4 neutropenia (n = 1) and neutropenic fever (n = 1) as the most prominent side-effects. Conclusions: Sequential CTx and CCRT prior to surgery are feasible and effective for high-risk GC. Trial registration number: NCT02495493.

Original languageEnglish
Pages (from-to)143-149
Number of pages7
JournalRadiotherapy and Oncology
Volume140
DOIs
StatePublished - 1 Nov 2019

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Chemoradiotherapy
Stomach Neoplasms
Drug Therapy
docetaxel
Cisplatin
Carcinoma
Radiation Dosage
Neutropenia
Fever
Survival Rate
Lymph Nodes
Safety
titanium silicide

Keywords

  • Gastric cancer
  • Preoperative chemoradiotherapy
  • Preoperative chemotherapy

Cite this

Kim, Hyo Song ; Koom, Woong Sub ; Baek, Song Ee ; Kim, Hyoung Il ; Jung, Minkyu ; Beom, Seung Hoon ; Kang, Beodeul ; Kim, Hyunki ; Chang, Jee Suk ; Choi, Yoon Young ; Son, Taeil ; Cheong, Jae Ho ; Noh, Sung Hoon ; Kim, Eun Hye ; Park, Jun Chul ; Shin, Sung Kwan ; Lee, Sang Kil ; Lee, Yong Chan ; Shin, Su Jin ; Chung, Hyunsoo ; Jung, Inkyung ; Chung, Hyun Cheol ; Lim, Joon Seok ; Hyung, Woo Jin ; Rha, Sun Young. / Phase II trial of preoperative sequential chemotherapy followed by chemoradiotherapy for high-risk gastric cancer. In: Radiotherapy and Oncology. 2019 ; Vol. 140. pp. 143-149.
@article{9e18f18b4f7548f2a4933cc15916dcda,
title = "Phase II trial of preoperative sequential chemotherapy followed by chemoradiotherapy for high-risk gastric cancer",
abstract = "Background and purpose: To evaluate the safety and efficacy of preoperative chemotherapy (CTx) followed by chemoradiotherapy (CCRT) for high-risk gastric cancer (GC). Methods and materials: The inclusion criteria were as follows: (1) Borrmann type 4; (2) large Borrmann type 3 (≥8 cm); (3) single bulky (≥3 cm × 1) or multiple lymph nodes (≥1.5 cm × 3). Patients received two 21-day courses of induction CTx of TS-1 (35 mg/m2, p.o, twice daily on days 1–14), docetaxel (30 mg/m2, i.v., days 1 and 8), and cisplatin (30 mg/m2, i.v., days 1 and 8) followed by CCRT (two courses of TS-1 and cisplatin in combination with 45 Gy radiation). Results: Forty-two patients were enrolled between March 2014 and February 2016, and 39 of these completed sequential CTx and CCRT. Among the 33 patients who underwent R0 resection, the pathologic response rate was 39.4{\%} [no residual carcinoma (n = 5, 15.2{\%}), with 1–10{\%} residual carcinoma (n = 8, 24.2{\%})]. Overall, 4 patients (12.1{\%}) were pathologic stage 0, 7 (21.2{\%}) were stage I, 10 (30.3{\%}) were stage II, and 12 (36.4{\%}) were stage III. The overall survival rate at 3 years was 77.9{\%} for stages 0 and I, 66.8{\%} for stages II–III, and 33.3{\%} for unresectable cases (P = 0.001). Toxicity was mild to moderate with grade 4 neutropenia (n = 1) and neutropenic fever (n = 1) as the most prominent side-effects. Conclusions: Sequential CTx and CCRT prior to surgery are feasible and effective for high-risk GC. Trial registration number: NCT02495493.",
keywords = "Gastric cancer, Preoperative chemoradiotherapy, Preoperative chemotherapy",
author = "Kim, {Hyo Song} and Koom, {Woong Sub} and Baek, {Song Ee} and Kim, {Hyoung Il} and Minkyu Jung and Beom, {Seung Hoon} and Beodeul Kang and Hyunki Kim and Chang, {Jee Suk} and Choi, {Yoon Young} and Taeil Son and Cheong, {Jae Ho} and Noh, {Sung Hoon} and Kim, {Eun Hye} and Park, {Jun Chul} and Shin, {Sung Kwan} and Lee, {Sang Kil} and Lee, {Yong Chan} and Shin, {Su Jin} and Hyunsoo Chung and Inkyung Jung and Chung, {Hyun Cheol} and Lim, {Joon Seok} and Hyung, {Woo Jin} and Rha, {Sun Young}",
year = "2019",
month = "11",
day = "1",
doi = "10.1016/j.radonc.2019.06.029",
language = "English",
volume = "140",
pages = "143--149",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",

}

Kim, HS, Koom, WS, Baek, SE, Kim, HI, Jung, M, Beom, SH, Kang, B, Kim, H, Chang, JS, Choi, YY, Son, T, Cheong, JH, Noh, SH, Kim, EH, Park, JC, Shin, SK, Lee, SK, Lee, YC, Shin, SJ, Chung, H, Jung, I, Chung, HC, Lim, JS, Hyung, WJ & Rha, SY 2019, 'Phase II trial of preoperative sequential chemotherapy followed by chemoradiotherapy for high-risk gastric cancer', Radiotherapy and Oncology, vol. 140, pp. 143-149. https://doi.org/10.1016/j.radonc.2019.06.029

Phase II trial of preoperative sequential chemotherapy followed by chemoradiotherapy for high-risk gastric cancer. / Kim, Hyo Song; Koom, Woong Sub; Baek, Song Ee; Kim, Hyoung Il; Jung, Minkyu; Beom, Seung Hoon; Kang, Beodeul; Kim, Hyunki; Chang, Jee Suk; Choi, Yoon Young; Son, Taeil; Cheong, Jae Ho; Noh, Sung Hoon; Kim, Eun Hye; Park, Jun Chul; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan; Shin, Su Jin; Chung, Hyunsoo; Jung, Inkyung; Chung, Hyun Cheol; Lim, Joon Seok; Hyung, Woo Jin; Rha, Sun Young.

In: Radiotherapy and Oncology, Vol. 140, 01.11.2019, p. 143-149.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Phase II trial of preoperative sequential chemotherapy followed by chemoradiotherapy for high-risk gastric cancer

AU - Kim, Hyo Song

AU - Koom, Woong Sub

AU - Baek, Song Ee

AU - Kim, Hyoung Il

AU - Jung, Minkyu

AU - Beom, Seung Hoon

AU - Kang, Beodeul

AU - Kim, Hyunki

AU - Chang, Jee Suk

AU - Choi, Yoon Young

AU - Son, Taeil

AU - Cheong, Jae Ho

AU - Noh, Sung Hoon

AU - Kim, Eun Hye

AU - Park, Jun Chul

AU - Shin, Sung Kwan

AU - Lee, Sang Kil

AU - Lee, Yong Chan

AU - Shin, Su Jin

AU - Chung, Hyunsoo

AU - Jung, Inkyung

AU - Chung, Hyun Cheol

AU - Lim, Joon Seok

AU - Hyung, Woo Jin

AU - Rha, Sun Young

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Background and purpose: To evaluate the safety and efficacy of preoperative chemotherapy (CTx) followed by chemoradiotherapy (CCRT) for high-risk gastric cancer (GC). Methods and materials: The inclusion criteria were as follows: (1) Borrmann type 4; (2) large Borrmann type 3 (≥8 cm); (3) single bulky (≥3 cm × 1) or multiple lymph nodes (≥1.5 cm × 3). Patients received two 21-day courses of induction CTx of TS-1 (35 mg/m2, p.o, twice daily on days 1–14), docetaxel (30 mg/m2, i.v., days 1 and 8), and cisplatin (30 mg/m2, i.v., days 1 and 8) followed by CCRT (two courses of TS-1 and cisplatin in combination with 45 Gy radiation). Results: Forty-two patients were enrolled between March 2014 and February 2016, and 39 of these completed sequential CTx and CCRT. Among the 33 patients who underwent R0 resection, the pathologic response rate was 39.4% [no residual carcinoma (n = 5, 15.2%), with 1–10% residual carcinoma (n = 8, 24.2%)]. Overall, 4 patients (12.1%) were pathologic stage 0, 7 (21.2%) were stage I, 10 (30.3%) were stage II, and 12 (36.4%) were stage III. The overall survival rate at 3 years was 77.9% for stages 0 and I, 66.8% for stages II–III, and 33.3% for unresectable cases (P = 0.001). Toxicity was mild to moderate with grade 4 neutropenia (n = 1) and neutropenic fever (n = 1) as the most prominent side-effects. Conclusions: Sequential CTx and CCRT prior to surgery are feasible and effective for high-risk GC. Trial registration number: NCT02495493.

AB - Background and purpose: To evaluate the safety and efficacy of preoperative chemotherapy (CTx) followed by chemoradiotherapy (CCRT) for high-risk gastric cancer (GC). Methods and materials: The inclusion criteria were as follows: (1) Borrmann type 4; (2) large Borrmann type 3 (≥8 cm); (3) single bulky (≥3 cm × 1) or multiple lymph nodes (≥1.5 cm × 3). Patients received two 21-day courses of induction CTx of TS-1 (35 mg/m2, p.o, twice daily on days 1–14), docetaxel (30 mg/m2, i.v., days 1 and 8), and cisplatin (30 mg/m2, i.v., days 1 and 8) followed by CCRT (two courses of TS-1 and cisplatin in combination with 45 Gy radiation). Results: Forty-two patients were enrolled between March 2014 and February 2016, and 39 of these completed sequential CTx and CCRT. Among the 33 patients who underwent R0 resection, the pathologic response rate was 39.4% [no residual carcinoma (n = 5, 15.2%), with 1–10% residual carcinoma (n = 8, 24.2%)]. Overall, 4 patients (12.1%) were pathologic stage 0, 7 (21.2%) were stage I, 10 (30.3%) were stage II, and 12 (36.4%) were stage III. The overall survival rate at 3 years was 77.9% for stages 0 and I, 66.8% for stages II–III, and 33.3% for unresectable cases (P = 0.001). Toxicity was mild to moderate with grade 4 neutropenia (n = 1) and neutropenic fever (n = 1) as the most prominent side-effects. Conclusions: Sequential CTx and CCRT prior to surgery are feasible and effective for high-risk GC. Trial registration number: NCT02495493.

KW - Gastric cancer

KW - Preoperative chemoradiotherapy

KW - Preoperative chemotherapy

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U2 - 10.1016/j.radonc.2019.06.029

DO - 10.1016/j.radonc.2019.06.029

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SN - 0167-8140

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