[Neoadjuvant chemotherapy for locally advanced gastric cancer].
Only surgical resection offers cure in gastric cancer. Curative resection unfortunately is possible only in about every second patient diagnosed with gastric cancer. Neoadjuvant chemotherapy may help to reach R0 resection in patients with locally advanced gastric cancer.


OBJECTIVE
To evaluate the ability of ECF neoadjuvant chemotherapy in locally advanced gastric cancer.


METHODS
Between December 1998 and April 2003 twenty-four patients with locally advanced gastric cancer were given neoadjuvant chemotherapy according to the ECF scheme. Before treatment, staging examinations were carried out: endoscopy, barium swallow, chest X-ray, computer-tomography and laparotomy or diagnostic laparoscopy. We treated patients with four three-weeks-long courses of chemotherapy with bolus injection of epirubicin and cisplatin on day 1, and continuous infusion of 5-fluorouracil on day 1 to 21. Twelve weeks long treatment was followed by 4 weeks free of treatment, than staging was repeated to determine response.


RESULTS
45.83% response rate was achieved. One complete response was observed. Ten patients showed partial response, 3 stable diseases and 10 progressive disease were detected. Twenty-one patients were operated on. Sixteen resections were carried out, ten with curative intent. Overall survival and disease free survival in the whole group were 12.19 and 8.66 months, while in patients with R0 resection 20.66 and 18.33 months.


CONCLUSIONS
Neoadjuvant chemotherapy provides a hope for cure for patient with locally advanced gastric cancer.
Kalmár
Katalin
K
PTE AOK Sebészeti Klinika, 7643 Pécs Ifjúság u. 13. kkalmar@aok.pte.hu
Cseke
László
L
Káposztás
Zsolt
Z
Horváth
Gábor
G
Varga
Erika
E
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D015251:Epirubicin; D002945:Cisplatin; D005472:Fluorouracil