Is chemoradiation effective or harmful for stage VI gastric cancer patients?

Yoshirou Saikawa, Tetsuro Kubota, Tsunehiro Takahashi, Yukako Akatsu, Rieko Nakamura, Masashi Yoshida, Naoyuki Shigematsu, Yoshihide Otani, Koichiro Kumai, Toshifumi Hibi, Masaki Kitajima

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

We aim to clarify beneficial effect of pre-operative radiation with chemotherapy in highly advanced gastric cancer patients, evaluating histological response, toxicity and patients' quality of life (QOL). We used pre-operative radiation with S-1 and low-dose cisplatin to treat 8 patients with highly advanced gastric cancer (clinical stage IV) in a pilot study. Clinical staging after therapy showed 5 PRs (partial response), 2 NCs (no change), and 1 PD (partial disease) following evaluation of the primary tumor and suspicious metastatic lesions in the lymph nodes, esophagus, liver, and peritoneum, for a response rate of 62.5% (5/8 cases). Of 8 patients, 6 underwent surgery, and 2 of these 6 patients had a histologically complete response (grade 3 effect) and 3 patients had a partial response (grade 2 effect), suggesting that a high histological response (5/6 cases; 83.3%) is expected by the chemoradiation. The survival analysis showed that 5 out of the 8 patients died within 10 months after initiating therapy, while 3 patients are alive without recurrence at 15, 18, and 30 months after therapy, suggesting a relatively good outcome for clinical stage IV gastric cancer. All cases showed grade 2-4 bone marrow suppression toxicity and/or grade 0-2 gastrointestinal toxicity, while 5 out of 8 patients (62.5%) showed improvement in appetite loss at the end of the therapy, indicating that the patients' quality of life (QOL) was preserved. Chemoradiation may be a powerful regimen for obtaining histological response with tolerable toxicity and improved QOL in highly advanced gastric cancer patients.

Original languageEnglish
Pages (from-to)865-870
Number of pages6
JournalOncology reports
Volume13
Issue number5
Publication statusPublished - 2005 May 1

Keywords

  • Cisplatin
  • Gastric cancer
  • Pre-operative chemoradiation
  • S-1

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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  • Cite this

    Saikawa, Y., Kubota, T., Takahashi, T., Akatsu, Y., Nakamura, R., Yoshida, M., Shigematsu, N., Otani, Y., Kumai, K., Hibi, T., & Kitajima, M. (2005). Is chemoradiation effective or harmful for stage VI gastric cancer patients? Oncology reports, 13(5), 865-870.