Feasibility and Safety of Perioperative Chemotherapy With Fluorouracil Plus Leucovorin, Oxaliplatin, and Docetaxel for Locally Advanced Gastric Cancer Patients in China
BackgroundNeoadjuvant fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT) has shown significant benefits for gastric cancer patients. However, it has not been well accepted in Asian countries. We conducted a prospective study on the safety and feasibility of the FLOT regimen in Chinese p...
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doaj-021d4adf354742c9bfe6d8fb656e83892021-01-18T05:46:53ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-01-011010.3389/fonc.2020.567529567529Feasibility and Safety of Perioperative Chemotherapy With Fluorouracil Plus Leucovorin, Oxaliplatin, and Docetaxel for Locally Advanced Gastric Cancer Patients in ChinaBirendra Kumar Sah0Wei Xu1Benyan Zhang2Huan Zhang3Fei Yuan4Jian Li5Wentao Liu6Chao Yan7Chen Li8Min Yan9Zhenggang Zhu10Zhenggang Zhu11Department of General Surgery, Gastrointestinal Surgery Unit, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of General Surgery, Gastrointestinal Surgery Unit, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Pathology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Radiology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Pathology, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaClinical Research Center, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of General Surgery, Gastrointestinal Surgery Unit, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of General Surgery, Gastrointestinal Surgery Unit, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of General Surgery, Gastrointestinal Surgery Unit, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of General Surgery, Gastrointestinal Surgery Unit, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of General Surgery, Gastrointestinal Surgery Unit, Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaShanghai Key Laboratory of Gastric Neoplasms, Shanghai Institute of Digestive Surgery, Shanghai, ChinaBackgroundNeoadjuvant fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT) has shown significant benefits for gastric cancer patients. However, it has not been well accepted in Asian countries. We conducted a prospective study on the safety and feasibility of the FLOT regimen in Chinese patients.MethodsPatients with adenocarcinoma of the stomach or esophagogastric junction received four cycles of neoadjuvant chemotherapy (NAC) and four cycles of adjuvant chemotherapy (AC) with the FLOT regimen. The completion status of chemotherapy, adverse events, postoperative morbidities, and pathological tumor regression were analyzed. The 2-year overall survival (OS) and relapse-free survival are presented.ResultsAltogether, 10 patients were enrolled, and all patients completed four cycles of neoadjuvant chemotherapy. There were no severe hematological adverse events (grade 3 or above), except for a case of grade 3 anemia. All 10 patients underwent radical gastrectomy. Nine patients had R0 resection, and three patients had complete or subtotal pathological tumor regression. Nine patients completed four cycles of adjuvant chemotherapy, but only one patient completed the full dose of adjuvant chemotherapy. The dose of adjuvant chemotherapy was reduced by 25% or less in the other patients. The median follow-up time was 23.13 months, eight patients achieved the overall survival endpoint, and seven patients had relapse-free survival for this period. Two patients died of disease progression.ConclusionsOur study demonstrates that the neoadjuvant FLOT regimen is safe and effective for Chinese patients. Dose adjustment is necessary for adjuvant chemotherapy. The pathological regression and survival rates need reevaluation in a larger cohort. The trial is registered with ClinicalTrials.gov (number NCT03646591).https://www.frontiersin.org/articles/10.3389/fonc.2020.567529/fullgastric cancerneoadjuvant chemotherapyadjuvant chemotherapyTRGFLOT regimen |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Birendra Kumar Sah Wei Xu Benyan Zhang Huan Zhang Fei Yuan Jian Li Wentao Liu Chao Yan Chen Li Min Yan Zhenggang Zhu Zhenggang Zhu |
spellingShingle |
Birendra Kumar Sah Wei Xu Benyan Zhang Huan Zhang Fei Yuan Jian Li Wentao Liu Chao Yan Chen Li Min Yan Zhenggang Zhu Zhenggang Zhu Feasibility and Safety of Perioperative Chemotherapy With Fluorouracil Plus Leucovorin, Oxaliplatin, and Docetaxel for Locally Advanced Gastric Cancer Patients in China Frontiers in Oncology gastric cancer neoadjuvant chemotherapy adjuvant chemotherapy TRG FLOT regimen |
author_facet |
Birendra Kumar Sah Wei Xu Benyan Zhang Huan Zhang Fei Yuan Jian Li Wentao Liu Chao Yan Chen Li Min Yan Zhenggang Zhu Zhenggang Zhu |
author_sort |
Birendra Kumar Sah |
title |
Feasibility and Safety of Perioperative Chemotherapy With Fluorouracil Plus Leucovorin, Oxaliplatin, and Docetaxel for Locally Advanced Gastric Cancer Patients in China |
title_short |
Feasibility and Safety of Perioperative Chemotherapy With Fluorouracil Plus Leucovorin, Oxaliplatin, and Docetaxel for Locally Advanced Gastric Cancer Patients in China |
title_full |
Feasibility and Safety of Perioperative Chemotherapy With Fluorouracil Plus Leucovorin, Oxaliplatin, and Docetaxel for Locally Advanced Gastric Cancer Patients in China |
title_fullStr |
Feasibility and Safety of Perioperative Chemotherapy With Fluorouracil Plus Leucovorin, Oxaliplatin, and Docetaxel for Locally Advanced Gastric Cancer Patients in China |
title_full_unstemmed |
Feasibility and Safety of Perioperative Chemotherapy With Fluorouracil Plus Leucovorin, Oxaliplatin, and Docetaxel for Locally Advanced Gastric Cancer Patients in China |
title_sort |
feasibility and safety of perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel for locally advanced gastric cancer patients in china |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2021-01-01 |
description |
BackgroundNeoadjuvant fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT) has shown significant benefits for gastric cancer patients. However, it has not been well accepted in Asian countries. We conducted a prospective study on the safety and feasibility of the FLOT regimen in Chinese patients.MethodsPatients with adenocarcinoma of the stomach or esophagogastric junction received four cycles of neoadjuvant chemotherapy (NAC) and four cycles of adjuvant chemotherapy (AC) with the FLOT regimen. The completion status of chemotherapy, adverse events, postoperative morbidities, and pathological tumor regression were analyzed. The 2-year overall survival (OS) and relapse-free survival are presented.ResultsAltogether, 10 patients were enrolled, and all patients completed four cycles of neoadjuvant chemotherapy. There were no severe hematological adverse events (grade 3 or above), except for a case of grade 3 anemia. All 10 patients underwent radical gastrectomy. Nine patients had R0 resection, and three patients had complete or subtotal pathological tumor regression. Nine patients completed four cycles of adjuvant chemotherapy, but only one patient completed the full dose of adjuvant chemotherapy. The dose of adjuvant chemotherapy was reduced by 25% or less in the other patients. The median follow-up time was 23.13 months, eight patients achieved the overall survival endpoint, and seven patients had relapse-free survival for this period. Two patients died of disease progression.ConclusionsOur study demonstrates that the neoadjuvant FLOT regimen is safe and effective for Chinese patients. Dose adjustment is necessary for adjuvant chemotherapy. The pathological regression and survival rates need reevaluation in a larger cohort. The trial is registered with ClinicalTrials.gov (number NCT03646591). |
topic |
gastric cancer neoadjuvant chemotherapy adjuvant chemotherapy TRG FLOT regimen |
url |
https://www.frontiersin.org/articles/10.3389/fonc.2020.567529/full |
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