ASO Author Reflections: Efficacy of Adjuvant S-1 Versus XELOX Chemotherapy for Gastric Cancer

Excerpt

Although radical gastrectomy is performed for curative resection of gastric cancer, recurrence is a common problem for patients with advanced gastric cancer. After the year 2000, several large-scale trials showed positive results of chemoradiation or perioperative chemotherapy; however, the surgical strategies of those trials were not standardized, with only a few patients undergoing D2 lymph node dissection. Because D2 lymph node dissection is currently considered a standard procedure for advanced gastric cancer, the ACTS-GC1 and CLASSIC2 trials were valuable studies that confirmed the beneficial effect of postoperative adjuvant chemotherapy after D2 lymph node dissection. The ACTS-GC trial showed the efficacy of novel oral fluoropyrimidine S-1, whereas the CLASSIC trial reported the beneficial effect of capecitabine plus oxaliplatin (XELOX). After completion of these trials, S-1 and XELOX chemotherapies have been widely used as representative adjuvant regimens; however, no study directly compared the two regimens. This study aimed to compare the efficacy of adjuvant S-1 and XELOX chemotherapy for patients with advanced gastric cancer. …