title: Paclitaxel and concurrent radiation for gastric cancer.
abstract: OBJECTIVE
  To determine the activity and toxicity of paclitaxel and concurrent radiation for gastric cancer.
  
  
  METHODS
  Twenty-seven patients were studied. Twenty-five had proximal gastric cancers, two had distal cancers. Eight had esophageal extension, 6 had celiac adenopathy, and 7 had retroperitoneal adenopathy. Patients received paclitaxel, 50 mg/m(2) by 3-hour intravenous (IV) infusion, weekly, on days 1, 8, 15, 22, and 29. Radiation was administered concurrently to a total dose of 45.0 Gy, in 1.80 Gy fractions, for 25 treatments. Patients who were medically or surgically inoperable received a sixth week of paclitaxel with a radiation boost to 50.4 Gy.
  
  
  RESULTS
  Esophagitis and gastritis were the most important toxicities, Grade 3 in four patients (15%), and Grade 4 in three patients (11%). Five patients (19%) had Grade 3 nausea. The overall response rate was 56%, including three patients (11%) with a complete response. The 2-year progression-free and overall survival rates were 29% and 31%, respectively.
  
  
  CONCLUSIONS
  Concurrent paclitaxel and radiation demonstrates substantial local-regional activity in gastric cancer. Future investigations combining paclitaxel and radiation with other local-regional and systemic treatments are warranted.
authors.affiliation: The Brown University Oncology Group, Providence, RI 02906, USA. hsafran@rihosp.edu
authors.forename: H
authors.initials: H
authors.lastname: Safran
authors.forename: H J
authors.initials: HJ
authors.lastname: Wanebo
authors.forename: P J
authors.initials: PJ
authors.lastname: Hesketh
authors.forename: P
authors.initials: P
authors.lastname: Akerman
authors.forename: D
authors.initials: D
authors.lastname: Ianitti
authors.forename: W
authors.initials: W
authors.lastname: Cioffi
authors.forename: T
authors.initials: T
authors.lastname: DiPetrillo
authors.forename: B
authors.initials: B
authors.lastname: Wolf
authors.forename: J
authors.initials: J
authors.lastname: Koness
authors.forename: R
authors.initials: R
authors.lastname: McAnaw
authors.forename: T
authors.initials: T
authors.lastname: Moore
authors.forename: M H
authors.initials: MH
authors.lastname: Chen
authors.forename: K
authors.initials: K
authors.lastname: Radie-Keane
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000627:therapeutic use*; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use*; D011859:Radiography; D011879:Radiotherapy Dosage; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D016019:Survival Analysis
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D011838:Radiation-Sensitizing Agents; D017239:Paclitaxel