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BMC Cancer
Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

A prospective phase I study of hypo-fractionated neoadjuvant radiotherapy for locally advanced gastric cancer

Authors: Ning Li, Xin Wang, Yuan Tang, Dongbing Zhao, Yihebali Chi, Lin Yang, Liming Jiang, Jun Jiang, Wenyang Liu, Yu Tang, Hui Fang, Yueping Liu, Yongwen Song, Shulian Wang, Jing Jin, Yexiong Li

Published in: BMC Cancer | Issue 1/2018

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Abstract

Background

Previous studies have reported that neoadjuvant chemoradiotherapy can downstage the advanced gastric cancer. However, no studies are available on the application of hypo-radiotherapy to neoadjuvant radiotherapy. This study sought to assess the maximum tolerated dose (MTD) and dose-limited toxicity (DLT) of hypo-fractionated chemoradiotherapy for local advanced gastric cancer.

Method

Patients with cT3–4 and/or lymph node-positive locally advanced gastric cancer or Siewert II/III esophagogastric junction adenocarcinoma were enrolled. Preoperative chemoradiation was followed by 3 cycles of oxaliplatin + S-1 neoadjuvant chemotherapy with an interval duration of 3–4 weeks. D2 resection was performed 2–4 weeks after neoadjuvant therapy. Three cycles of adjuvant chemotherapy were planned after surgery. Intensity-modulated radiotherapy (IMRT) was used. The radiotherapy dose level was defined using three levels, namely, 40.0 Gy/2.5 Gy, 41.6 Gy/2.6 Gy, 43.2 Gy/2.7 Gy delivered concurrently with S-1 at 80 mg/m2.

Results

From May 2016 to Dec 2016, nine patients with a median age of 63 years were enrolled in this study. The most common grade I-III adverse events were leukopenia (88.9%), nausea (88.9%), vomiting (77.8%) and weight loss (66.7%). Grade III adverse events consisted of vomiting and weight loss.

Conclusion

The MTD of hypo-fractionated radiotherapy for locally advanced gastric cancer was 40.0 Gy/2.5 Gy, and the DLTs were vomiting and weight loss.

Trial registration

Clinicaltrials.gov ID: NCT03427684 (Retrospectively registered on February 9, 2018).
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Metadata
Title
A prospective phase I study of hypo-fractionated neoadjuvant radiotherapy for locally advanced gastric cancer
Authors
Ning Li
Xin Wang
Yuan Tang
Dongbing Zhao
Yihebali Chi
Lin Yang
Liming Jiang
Jun Jiang
Wenyang Liu
Yu Tang
Hui Fang
Yueping Liu
Yongwen Song
Shulian Wang
Jing Jin
Yexiong Li
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-4707-9

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