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Surgery Today
Published in: Surgery Today 9/2016

01-09-2016 | Original Article

Feasibility of neoadjuvant S-1 and oxaliplatin followed by surgery for resectable advanced gastric adenocarcinoma

Authors: Yoshitaka Honma, Yasuhide Yamada, Tetsuji Terazawa, Atsuo Takashima, Satoru Iwasa, Ken Kato, Tetsuya Hamaguchi, Yasuhiro Shimada, Masaki Ohashi, Shinji Morita, Takeo Fukagawa, Nozomu Machida, Hitoshi Katai

Published in: Surgery Today | Issue 9/2016

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Abstract

Purpose

In Japan, the administration of S-1 following D2 gastrectomy is a standard treatment for stage II/III gastric cancer (GC). However, the survival of stage IIIB/IIIC GC remains unsatisfactory. To improve this, we conducted a multicenter phase II study to evaluate the safety and efficacy of a neoadjuvant S-1 and oxaliplatin regimen (SOX) followed by surgery targeted at stage III GC.

Methods

Oxaliplatin was administered intravenously (130 mg/m2) on day 1, and S-1 was administered orally (40 mg/m2, twice a day) for 14 days followed by a seven-day rest period. After three cycles of therapy, D2 gastrectomy was performed.

Results

A total of 14 patients were enrolled and completed the protocol treatment. Grade 3/4 toxicities included thrombocytopenia (21.4 %), anorexia (14.3 %), and diarrhea (7.1 %). Seven patients (50 %) underwent total gastrectomy, and seven patients underwent distal gastrectomy. Grade 3/4 surgical complications included pancreatic fistula (21.4 %) and lung infection (7.1 %). The pathological response rate was 85.7 %.

Conclusion

Although our data are limited and preliminary, neoadjuvant SOX followed by surgery can be performed safely with a high pathological response rate in patients with resectable advanced GC. Further investigation of this neoadjuvant approach is warranted.
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Metadata
Title
Feasibility of neoadjuvant S-1 and oxaliplatin followed by surgery for resectable advanced gastric adenocarcinoma
Authors
Yoshitaka Honma
Yasuhide Yamada
Tetsuji Terazawa
Atsuo Takashima
Satoru Iwasa
Ken Kato
Tetsuya Hamaguchi
Yasuhiro Shimada
Masaki Ohashi
Shinji Morita
Takeo Fukagawa
Nozomu Machida
Hitoshi Katai
Publication date
01-09-2016
Publisher
Springer Japan
Published in
Surgery Today / Issue 9/2016
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-015-1276-2

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