title: [Value of normalization window of tumor vasculature in neoadjuvant chemotherapy for patients with unresectable gastric cancer].
abstract: OBJECTIVE
  To evaluate the value of normalization window of tumor vasculature (NWTV) in patients with unresectable gastric cancer undergoing neoadjuvant chemotherapy.
  
  
  METHODS
  From October 2010 to March 2011, 93 patients with unresectable advanced or locally advanced gastric carcinoma were prospectively collected and randomly divided to Group A(n=30), Group B(n=29), and Group C(n=34). Group A received FOLFOX4 as conventional neoadjuvant chemotherapy. Group B received FOLFOX4 plus bevacizumab. The treatment was adjusted in Group C according to the hypothesis of NWTV with neoadjuvant chemotherapy delivered 5 days after bevacizumab treatment. The efficacy, drug toxicity and clinical outcome were assessed and compared between the three groups.
  
  
  RESULTS
  There were no significant differences among the 3 groups in demographics(P>0.05). All the patients completed the neoadjuvant chemotherapy. Efficacy and toxicity between the three groups were comparable(P>0.05). The rates of tumor downstaging in the three groups were 56.7%(17/30), 72.4%(21/29), 85.3%(29/34), respectively, with a significantly lower downstaging rate in Group C as compared to Group A(P<0.05). R0 resection rates were 23.3%(7/30), 27.6%(8/29), 52.9% (18/34), respectively, with significantly higher R0 resection rate in Group C as compared to Group A and Group B(All P<0.05). There was no perioperative death in this cohort. Postoperative complications were comparable among the 3 groups(P>0.05).
  
  
  CONCLUSIONS
  Anti-angiogenesis agent can improve the efficacy of neoadjuvant chemotherapy in unresectable gastric cancer. Furthermore, administration according to NWTV may achieve better outcomes.
authors.affiliation: Department of Gastrointestinal Surgery, Wuhan University, Wuhan, China.
authors.forename: Yong-bin
authors.initials: YB
authors.lastname: Zheng
authors.forename: Feng-yu
authors.initials: FY
authors.lastname: Cao
authors.forename: Ke-jie
authors.initials: KJ
authors.lastname: Liu
authors.forename: Hong-fa
authors.initials: HF
authors.lastname: Gan
authors.forename: Xiao-bo
authors.initials: XB
authors.lastname: He
authors.forename: Shi-lun
authors.initials: SL
authors.lastname: Tong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009389:Neovascularization, Pathologic / Q000188:drug therapy; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000098:blood supply / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil