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Preoperative chemoradiotherapy in locally advanced gastric cancer, a phase I/II feasibility and efficacy study

Abstract

Objectives: This study was initiated to investigate the feasibility and efficacy of preoperative radiotherapy with weekly paclitaxel and carboplatin in locally advanced gastric cancer. Methods: In a prospective study, patients with locally advanced gastric cancer stage IB-IV(M0) were treated with chemoradiotherapy followed by surgery 4–6 weeks after the last irradiation. Chemoradiotherapy consisted of radiation to a total dose of 45 Gy given in 25 fractions of 1.8 Gy, combined with concurrent weekly carboplatin and paclitaxel. Results: Between December 2007 and January 2012, 25 patients with cT3 (64%) or cT4 (36%) gastric cancer were included. One patient discontinued concurrent chemotherapy in the 4th week due to toxicity, but completed radiotherapy. Another patient discontinued chemoradiotherapy after the 3rd week due to progressive disease. Grade III adverse events of chemoradiotherapy were: gastrointestinal 12%, haematological 12% and other 8%. All patients, except one who developed progressive disease, were operated. Surgical complications were: general/infectious 48%, anastomotic leakage 12%, and bowel perforation 8%. Postoperative mortality was 4%. Microscopically radical resection rate was 72%. Pathological complete response rate was 16% and near complete response rate 24%. Conclusions: In this study, preoperative chemoradiotherapy for patients with locally advanced gastric cancer was associated with manageable toxicity and encouraging pathological  More>>
Authors:
Trip, Anouk K.; [1]  Poppema, Boelo J.; [2]  Berge Henegouwen, Mark I. van; [3]  Siemerink, Ester; [4]  Beukema, Jannet C.; [5]  Verheij, Marcel; [1]  Plukker, John T.M.; [6]  Richel, Dick J.; [7]  Hulshof, Maarten C.C.M.; [8]  Sandick, Johanna W. van; [9]  Cats, Annemieke; [10]  Jansen, Edwin P.M.; [1]  Hospers, Geke A.P., E-mail: g.a.p.hospers@umcg.nl [2] 
  1. Department of Radiation Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)
  2. Department of Medical Oncology, University Medical Centre Groningen (Netherlands)
  3. Department of Surgical Oncology, Academic Medical Centre – University of Amsterdam (Netherlands)
  4. Department of Internal Medicine, Ziekenhuisgroep Twente, Hengelo (Netherlands)
  5. Department of Radiation Oncology, University Medical Centre Groningen (Netherlands)
  6. Department of Surgical Oncology, University Medical Centre Groningen (Netherlands)
  7. Department of Medical Oncology, Academic Medical Centre – University of Amsterdam (Netherlands)
  8. Department of Radiation Oncology, Academic Medical Centre – University of Amsterdam (Netherlands)
  9. Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)
  10. Department of Gastroenterology and Hepatology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)
Publication Date:
Aug 15, 2014
Product Type:
Journal Article
Resource Relation:
Journal Name: Radiotherapy and Oncology; Journal Volume: 112; Journal Issue: 2; Other Information: Copyright (c) 2014 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; COMBINED THERAPY; IRRADIATION; LEAKS; MORTALITY; NEOPLASMS; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SURGERY; TOXICITY
OSTI ID:
22438408
Country of Origin:
Ireland
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0167-8140; CODEN: RAONDT; Other: PII: S0167-8140(14)00183-2; TRN: IE15R0247007942
Availability:
Available from http://dx.doi.org/10.1016/j.radonc.2014.05.003
Submitting Site:
INIS
Size:
page(s) 284-288
Announcement Date:
Mar 05, 2016

Citation Formats

Trip, Anouk K., Poppema, Boelo J., Berge Henegouwen, Mark I. van, Siemerink, Ester, Beukema, Jannet C., Verheij, Marcel, Plukker, John T.M., Richel, Dick J., Hulshof, Maarten C.C.M., Sandick, Johanna W. van, Cats, Annemieke, Jansen, Edwin P.M., and Hospers, Geke A.P., E-mail: g.a.p.hospers@umcg.nl. Preoperative chemoradiotherapy in locally advanced gastric cancer, a phase I/II feasibility and efficacy study. Ireland: N. p., 2014. Web. doi:10.1016/J.RADONC.2014.05.003.
Trip, Anouk K., Poppema, Boelo J., Berge Henegouwen, Mark I. van, Siemerink, Ester, Beukema, Jannet C., Verheij, Marcel, Plukker, John T.M., Richel, Dick J., Hulshof, Maarten C.C.M., Sandick, Johanna W. van, Cats, Annemieke, Jansen, Edwin P.M., & Hospers, Geke A.P., E-mail: g.a.p.hospers@umcg.nl. Preoperative chemoradiotherapy in locally advanced gastric cancer, a phase I/II feasibility and efficacy study. Ireland. doi:10.1016/J.RADONC.2014.05.003.
Trip, Anouk K., Poppema, Boelo J., Berge Henegouwen, Mark I. van, Siemerink, Ester, Beukema, Jannet C., Verheij, Marcel, Plukker, John T.M., Richel, Dick J., Hulshof, Maarten C.C.M., Sandick, Johanna W. van, Cats, Annemieke, Jansen, Edwin P.M., and Hospers, Geke A.P., E-mail: g.a.p.hospers@umcg.nl. 2014. "Preoperative chemoradiotherapy in locally advanced gastric cancer, a phase I/II feasibility and efficacy study." Ireland. doi:10.1016/J.RADONC.2014.05.003. https://www.osti.gov/servlets/purl/10.1016/J.RADONC.2014.05.003.
@misc{etde_22438408,
title = {Preoperative chemoradiotherapy in locally advanced gastric cancer, a phase I/II feasibility and efficacy study}
author = {Trip, Anouk K., Poppema, Boelo J., Berge Henegouwen, Mark I. van, Siemerink, Ester, Beukema, Jannet C., Verheij, Marcel, Plukker, John T.M., Richel, Dick J., Hulshof, Maarten C.C.M., Sandick, Johanna W. van, Cats, Annemieke, Jansen, Edwin P.M., and Hospers, Geke A.P., E-mail: g.a.p.hospers@umcg.nl}
abstractNote = {Objectives: This study was initiated to investigate the feasibility and efficacy of preoperative radiotherapy with weekly paclitaxel and carboplatin in locally advanced gastric cancer. Methods: In a prospective study, patients with locally advanced gastric cancer stage IB-IV(M0) were treated with chemoradiotherapy followed by surgery 4–6 weeks after the last irradiation. Chemoradiotherapy consisted of radiation to a total dose of 45 Gy given in 25 fractions of 1.8 Gy, combined with concurrent weekly carboplatin and paclitaxel. Results: Between December 2007 and January 2012, 25 patients with cT3 (64%) or cT4 (36%) gastric cancer were included. One patient discontinued concurrent chemotherapy in the 4th week due to toxicity, but completed radiotherapy. Another patient discontinued chemoradiotherapy after the 3rd week due to progressive disease. Grade III adverse events of chemoradiotherapy were: gastrointestinal 12%, haematological 12% and other 8%. All patients, except one who developed progressive disease, were operated. Surgical complications were: general/infectious 48%, anastomotic leakage 12%, and bowel perforation 8%. Postoperative mortality was 4%. Microscopically radical resection rate was 72%. Pathological complete response rate was 16% and near complete response rate 24%. Conclusions: In this study, preoperative chemoradiotherapy for patients with locally advanced gastric cancer was associated with manageable toxicity and encouraging pathological response rates.}
doi = {10.1016/J.RADONC.2014.05.003}
journal = {Radiotherapy and Oncology}
issue = {2}
volume = {112}
journal type = {AC}
place = {Ireland}
year = {2014}
month = {Aug}
}