title: [Neoadjuvant chemotherapy using TS-1 and CDDP against large type 3/Type 4/Bulky N 2 advanced gastric cancer].
abstract: This study was conducted to assess therapeutic results following neoadjuvant chemotherapy (NAC) for large type 3/type 4/Bulky N 2 advanced gastric cancer having a poor prognosis following resection. The subjects consisted of cases (< or = 75 y.o.) having large type 3 (diameter > or = 8 cm), type 4 or Bulky N 2 gastric cancer curable by resection based on preoperative imaging diagnostics. The NAC regimen consisted of TS-1 at 80-120 mg/body on days 1-21 p. o. and CDDP at 60 mg/m2 on day 8 divided. Upon completion of two courses of 4 weeks per course, gastrectomy with > or = D2 lymph node dissection was carried out on days 21-34. The average age of the subjects was 60.7 years, and the therapy completion rate was 80% (8/10 cases). Five of ten cases were responders diagnosed as grade 2 by histopathological examination of excised specimens (response rate 50%). Two of five responders were histopathologically evaluated as down-staging as a result of NAC (Stage III A--> f Stage I A, Stage IV--> f Stage I A). Three of the five non-responders have relapsed, and the relapse-free interval was an average 238 days. In the five responders,one has relapsed at 331 days,while the other 4 responders have shown no relapse yet. Although NAC consisting of TS-1 and CDDP is considered to be effective against advanced gastric cancer, a phase III study with surgical treatment only will be necessary to confirm its true value.
authors.affiliation: Dept. of Surgery, Gifu Municipal Hospital.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tanemura
authors.forename: Hiroo
authors.initials: H
authors.lastname: Oshita
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kanno
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Kusakabe
authors.forename: Tsuneaki
authors.initials: T
authors.lastname: Hatoh
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamada
authors.forename: Takahito
authors.initials: T
authors.lastname: Adachi
authors.forename: Kimitoshi
authors.initials: K
authors.lastname: Nishio
authors.forename: Shiro
authors.initials: S
authors.lastname: Saito
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tomita
authors.forename: Akihiko
authors.initials: A
authors.lastname: Sugiyama
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamada
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000008:administration & dosage; D011725:Pyridines / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016019:Survival Analysis; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D011725:Pyridines; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin