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Regional Arterial Infusion Chemotherapy improves the Pathological Response rate for advanced gastric cancer with Short-term Neoadjuvant Chemotherapy.

Wu ZF, Cao QH, Wu XY, Chen C, Xu Z, Li WS, Yao XQ, Liu FK - Sci Rep (2015)

Bottom Line: The benefits of regional arterial infusion chemotherapy were investigated separately.Regional arterial infusion NAC group had significantly better median RFS (48.0 versus 34.0 months) than the intravenous NAC group (P = 0.049).In conclusion, regional arterial infusion NAC can improve the pathological response rate of advanced gastric cancer treated with EOX regimen.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.

ABSTRACT
To identify clinicopathologic and treatment variables that could predict pathologic tumor response to short-term neoadjuvant chemotherapy (NAC) for patients with locally advanced gastric cancer. A retrospective analysis was conducted of 178 patients who underwent short-term NAC with EOX regimen followed by surgery from January 2008 to December 2010. Neoadjuvant treatment response was evaluated using tumor regression grade. Relationships between pathologic tumor response and clinicopathological factors were evaluated using logistic regression analysis. The benefits of regional arterial infusion chemotherapy were investigated separately. The postoperative pathological response rate was 46.1% (82/178) and 4 patients (2.2%) had complete pathological remission. Pathological response was significantly associated with tumor differentiation (P = 0.008), abnormal a-fetoprotein levels (P = 0.01) and administration approach to chemotherapy (intravenous versus regional arterial infusion chemotherapy) (P = 0.018). Most bone marrow toxicities, vomiting, nausea, alopecia, and fatigue were acceptable. Grade 3/4 toxicities were not commonly observed. The 3-year overall survival (OS) and recurrence free survival (RFS) were 67.0% and 53.0%, respectively. Regional arterial infusion NAC group had significantly better median RFS (48.0 versus 34.0 months) than the intravenous NAC group (P = 0.049). In conclusion, regional arterial infusion NAC can improve the pathological response rate of advanced gastric cancer treated with EOX regimen.

No MeSH data available.


Related in: MedlinePlus

Overall survival (OS) curves of tumor regression grade (TRG) 0–2 cases and TRG3-4 cases.The 1-, 3-, and 5-year OS of TRG0-2 cases were 82%, 60% and 37%, and of TRG3-4 cases were 91%, 76% and 59%, respectively (P = 0.002).
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f2: Overall survival (OS) curves of tumor regression grade (TRG) 0–2 cases and TRG3-4 cases.The 1-, 3-, and 5-year OS of TRG0-2 cases were 82%, 60% and 37%, and of TRG3-4 cases were 91%, 76% and 59%, respectively (P = 0.002).

Mentions: Patients were followed up until death or until December 31, 2014. Median follow-up was 48.25 months [95% confidence interval (CI) 40.75–58.0 months]. The 1- and 3-year RFS rates were 79% and 53%, and the 1-, 3-, and 5-year OS rates were 87%, 67%, and 47%. When the survival rate was separated by TRG, the 1- and 3-year RFS rate of TRG0–2 cases were 72% and 43%, whereas that of TRG3–4 cases were 88% and 65%,(P = 0.003) (Fig. 1). The 1-, 3-, and 5-year OS of TRG0–2 cases were 82%, 60% and 37%, whereas that of TRG3–4 cases were 91%, 76% and 59%, respectively (P = 0.002) (Fig. 2). There were no significant differences in surgical and clinical pathological characteristics of patients between intravenous NAC group and regional arterial infusion NAC group. (Table 4). The RFS and OS of patients in intravenous NAC group and regional arterial infusion NAC group are shown in Figs 3 and 4. Improved RFS rates were observed in the regional arterial infusion NAC group. The 1- and 3-year RFS rate of intravenous NAC group were 75% and 47%, whereas that of regional arterial infusion NAC group were 84% and 60%, (P = 0.049) (Fig. 3). However, there was no significant difference in OS between the two groups. The 1-, 3-, and 5-year OS rates were 84%, 65%, and 41% in the intravenous NAC group and 89%, 71%, and 53% in the regional arterial infusion NAC group, respectively (P = 0.137) (Fig. 4).


Regional Arterial Infusion Chemotherapy improves the Pathological Response rate for advanced gastric cancer with Short-term Neoadjuvant Chemotherapy.

Wu ZF, Cao QH, Wu XY, Chen C, Xu Z, Li WS, Yao XQ, Liu FK - Sci Rep (2015)

Overall survival (OS) curves of tumor regression grade (TRG) 0–2 cases and TRG3-4 cases.The 1-, 3-, and 5-year OS of TRG0-2 cases were 82%, 60% and 37%, and of TRG3-4 cases were 91%, 76% and 59%, respectively (P = 0.002).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664910&req=5

f2: Overall survival (OS) curves of tumor regression grade (TRG) 0–2 cases and TRG3-4 cases.The 1-, 3-, and 5-year OS of TRG0-2 cases were 82%, 60% and 37%, and of TRG3-4 cases were 91%, 76% and 59%, respectively (P = 0.002).
Mentions: Patients were followed up until death or until December 31, 2014. Median follow-up was 48.25 months [95% confidence interval (CI) 40.75–58.0 months]. The 1- and 3-year RFS rates were 79% and 53%, and the 1-, 3-, and 5-year OS rates were 87%, 67%, and 47%. When the survival rate was separated by TRG, the 1- and 3-year RFS rate of TRG0–2 cases were 72% and 43%, whereas that of TRG3–4 cases were 88% and 65%,(P = 0.003) (Fig. 1). The 1-, 3-, and 5-year OS of TRG0–2 cases were 82%, 60% and 37%, whereas that of TRG3–4 cases were 91%, 76% and 59%, respectively (P = 0.002) (Fig. 2). There were no significant differences in surgical and clinical pathological characteristics of patients between intravenous NAC group and regional arterial infusion NAC group. (Table 4). The RFS and OS of patients in intravenous NAC group and regional arterial infusion NAC group are shown in Figs 3 and 4. Improved RFS rates were observed in the regional arterial infusion NAC group. The 1- and 3-year RFS rate of intravenous NAC group were 75% and 47%, whereas that of regional arterial infusion NAC group were 84% and 60%, (P = 0.049) (Fig. 3). However, there was no significant difference in OS between the two groups. The 1-, 3-, and 5-year OS rates were 84%, 65%, and 41% in the intravenous NAC group and 89%, 71%, and 53% in the regional arterial infusion NAC group, respectively (P = 0.137) (Fig. 4).

Bottom Line: The benefits of regional arterial infusion chemotherapy were investigated separately.Regional arterial infusion NAC group had significantly better median RFS (48.0 versus 34.0 months) than the intravenous NAC group (P = 0.049).In conclusion, regional arterial infusion NAC can improve the pathological response rate of advanced gastric cancer treated with EOX regimen.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.

ABSTRACT
To identify clinicopathologic and treatment variables that could predict pathologic tumor response to short-term neoadjuvant chemotherapy (NAC) for patients with locally advanced gastric cancer. A retrospective analysis was conducted of 178 patients who underwent short-term NAC with EOX regimen followed by surgery from January 2008 to December 2010. Neoadjuvant treatment response was evaluated using tumor regression grade. Relationships between pathologic tumor response and clinicopathological factors were evaluated using logistic regression analysis. The benefits of regional arterial infusion chemotherapy were investigated separately. The postoperative pathological response rate was 46.1% (82/178) and 4 patients (2.2%) had complete pathological remission. Pathological response was significantly associated with tumor differentiation (P = 0.008), abnormal a-fetoprotein levels (P = 0.01) and administration approach to chemotherapy (intravenous versus regional arterial infusion chemotherapy) (P = 0.018). Most bone marrow toxicities, vomiting, nausea, alopecia, and fatigue were acceptable. Grade 3/4 toxicities were not commonly observed. The 3-year overall survival (OS) and recurrence free survival (RFS) were 67.0% and 53.0%, respectively. Regional arterial infusion NAC group had significantly better median RFS (48.0 versus 34.0 months) than the intravenous NAC group (P = 0.049). In conclusion, regional arterial infusion NAC can improve the pathological response rate of advanced gastric cancer treated with EOX regimen.

No MeSH data available.


Related in: MedlinePlus