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Caspian Journal of Internal Medicine، جلد ۱۲، شماره ۳، صفحات ۲۵۶-۲۶۲
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عنوان انگلیسی Post-neoadjuvant chemoradiotherapy tumor resectability following induction chemotherapy in locally advanced proximal gastric and adenocarcinoma of the esophagogastric junction: A clinical trial
چکیده انگلیسی مقاله Background: Pre-operative chemoradiotherapy (NACRT) of patients with proximal gastric and esophagogastric junction (EGJ) adenocarcinoma may result in increased local control and improved patients' survival rate. This study aimed to investigate the effect of NACRT on resectability of tumor in patients with proximal gastric and EGJ adenocarcinoma. Methods: In this single-arm clinical trial, patients with locally advanced proximal gastric and EGJ adenocarcinoma were included. Two courses of paclitaxel/carboplatin chemotherapy alone followed by NACRT with a similar treatment regimen and a total radiation dose of 45-50.4/1.8-2 Grays were prescribed. After surgery, patients were evaluated for resection rate, pathologic response rate, and post-surgical complications. Results: A total of 61 patients with a mean age of 65.9 years participated. Grades 1 and 2 were the most prevalent side effects, with grade 3 being the worst grade and exhibiting as leukopenia (4.9%) and thrombocytopenia (1.6%). 25 (41%) patients underwent surgery after NACRT. Post-surgery complication was reported in 20% of cases (including 8% mortality and 12% morbidity). R0 and R2 resection was observed in 88% and 12% of cases, respectively. Complete pathologic-response was achieved in 24% of patients. Conclusion: Paclitaxel/carboplatin based neoadjuvant chemotherapy was associated with potential resectability and appropriate pathologic response in patients with locally advanced proximal gastric and EGJ adenocarcinoma. However, by reducing patient tolerance to complete courses of weekly chemotherapy, induction chemotherapy lowered the effectiveness of concurrent chemotherapy and radiotherapy (as a sensitizing agent). Hence, induction chemotherapy proved to be more unbeneficial causing delayed treatment and reducing concurrent chemoradiotherapy tolerance.
کلیدواژه‌های انگلیسی مقاله neoadjuvant chemoradiotherapy, proximal gastric adenocarcinoma, esophagogastric junction (EGJ) adenocarcinoma
نویسندگان مقاله | Seyed Amir Aledavood
Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


| Kazem Anvari
Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


| Soodabeh Shahidsales
Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


| Sare Hosseini
Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


| Ali Emadi Torghabeh
Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


| Masume Masudian
Kosar Hospital, Semnan University of Medical Sciences, Semnan, Iran
نشانی اینترنتی http://caspjim.com/browse.php?a_code=A-10-1860-1&slc_lang=en&sid=1
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کد مقاله (doi)
زبان مقاله منتشر شده en
موضوعات مقاله منتشر شده Oncology
نوع مقاله منتشر شده Original Article
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