title: Docetaxel-based preoperative chemoradiation in localized gastric cancer: impact of pathological complete response on patient outcome.
abstract: OBJECTIVE
  This study was conducted to evaluate the feasibility, efficacy, and toxicities of docetaxel-based induction chemotherapy and chemoradiotherapy in patients with localized gastric or gastroesophageal adenocarcinoma.
  
  
  METHODS
  Patients with localized, operable gastric or gastroesophageal adenocarcinoma received two cycles of induction chemotherapy of fluorouracil, docetaxel, and cisplatin (TPF) followed by 45 Gy of radiation and concurrent fluorouracil plus docetaxel then surgery for nonmetastatic patients.
  
  
  RESULTS
  Forty-one patients were included. Pretreatment T3 was encountered in 56 % of patients while 61 % had N1 disease. A pathologic complete response (CR) was noted in 24 % of patients. Pathologic response was significantly associated with baseline T stage (P < 0.001) and N stage (P = 0.002). The 3-year overall survival (OS) and disease-free survival were 47.3 and 42.1 %, respectively. OS was significantly correlated with R0 resection (P = 0.027), pathological response (P = 0.01), dissected pathologically positive lymph node (P = 0.037), and postsurgery (T) stage (P = 0.02). Toxicities were manageable and there were no treatment-related deaths.
  
  
  CONCLUSIONS
  Docetaxel-based chemoradiotherapy in localized gastric adenocarcinoma patients resulted in 24 % path CR and was not associated with a higher percentage of postoperative complications. A well-designed randomized controlled trial is mandatory to further endorse this evolving approach.
authors.affiliation: Clinical Oncology Department, Faculty of Medicine, Alexandria University, Champlion Street, Alazarita, Alexandria 21131, Egypt.
authors.forename: Y
authors.initials: Y
authors.lastname: Rostom
authors.forename: H
authors.initials: H
authors.lastname: Zaghloul
authors.forename: G
authors.initials: G
authors.lastname: Khedr
authors.forename: W
authors.initials: W
authors.lastname: El-Shazly
authors.forename: D
authors.initials: D
authors.lastname: Abd-Allah
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D000077143:Docetaxel; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil