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Neoadjuvant Docetaxel, Capecitabine and Cisplatin (DXP) in Patients with Unresectable Locally Advanced or Metastatic Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This phase II study was conducted to evaluate the efficacy of neoadjuvant chemotherapy with docetaxel, cisplatin and capecitabine (DXP) in patients with unresectable locally advanced and/or intra-abdominal metastatic gastric cancers.

Methods

Patients with advanced gastric cancer (AGC), clinically unresectable because of local invasion or limited intra-abdominal metastasis in para-aortic lymph nodes and/or the peritoneum based on multidetector row computed tomography, were enrolled. DXP consisted of docetaxel 60 mg/m2 i.v. and cisplatin 60 mg/m2 i.v. on day 1, and capecitabine 937.5 mg/m2 twice daily p.o. on days 1–14 every 21 days. Surgery was performed after 4–6 cycles of DXP.

Results

Thirty-six (74%) of the 49 patients enrolled underwent surgery, and 31 (63%) had an R0 resection. R0 resection was possible in 15 of 21 patients (71%) with unresectable locally advanced lesions, 12 of 17 patients (70%) with para-aortic lymph node metastasis but only 4 of 11 patients (36%) with peritoneal metastasis. Grade 3/4 toxicities included neutropenia (69%), febrile neutropenia (4%) and hand–foot syndrome (8%).

Conclusions

Neoadjuvant DXP may offer a reasonable chance of curative surgery in AGC patients with unresectable locally advanced or para-aortic lymph node metastasis.

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Acknowledgment

The first two authors contributed equally to this work. Capecitabine and docetaxel were kindly provided by Roche Korea and Sanofi-Aventis Korea, respectively. There were no potential of conflicts of interest.

Author Contributions

Conception and design: Heung Moon Chang, Yoon-Koo Kang. Provision of study material or patients: Sun Jin Sym, Heung Moon Chang, Min-Hee Ryu, Jae-Lyun Lee, Tae Won Kim, Jeong Hwan Yook, Sung Tae Oh, Byung Sik Kim, Yoon-Koo Kang. Collection and assembly of data: Sun Jin Sym, Heung Moon Chang, Min-Hee Ryu, Jae-Lyun Lee. Data analysis and interpretation: Sun Jin Sym, Heung Moon Chang, Jae-Lyun Lee, Tae Won Kim, Yoon-Koo Kang. Manuscript writing: Sun Jin Sym, Min-Hee Ryu, Yoon-Koo Kang. Final approval of manuscript: Sun Jin Sym, Heung Moon Chang, Min-Hee Ryu, Jae-Lyun Lee, Tae Won Kim, Jeong Hwan Yook, Sung Tae Oh, Byung Sik Kim, Yoon-Koo Kang.

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Author notes

  1. Sun Jin Sym MD

    Present address: Gachon University Gil Hospital, Incheon, Korea

Authors and Affiliations

  1. Division of Oncology, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Sun Jin Sym MD, Heung Moon Chang PhD, Min-Hee Ryu PhD, Jae-Lyun Lee PhD, Tae Won Kim PhD & Yoon-Koo Kang PhD

  2. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jeong Hwan Yook PhD, Sung Tae Oh PhD & Byung Sik Kim PhD

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  1. Sun Jin Sym MD
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Correspondence to Yoon-Koo Kang PhD.

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Sym, S.J., Chang, H.M., Ryu, MH. et al. Neoadjuvant Docetaxel, Capecitabine and Cisplatin (DXP) in Patients with Unresectable Locally Advanced or Metastatic Gastric Cancer. Ann Surg Oncol 17, 1024–1032 (2010). https://doi.org/10.1245/s10434-009-0838-1

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  • DOI: https://doi.org/10.1245/s10434-009-0838-1

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