title: Treatment of locally advanced gastric cancer with the XELOX program of neoadjuvantchemotherapy combined with laparoscopic surgery: the experience in China.
abstract: OBJECTIVE
  Although the XELOX regimen has been recommended as first-line adjuvant chemotherapy for advanced gastric cancer (AGC), its role in a neoadjuvant setting is not well established. Therefore, we aimed to assess the clinical effect of XELOX neoadjuvant chemotherapy on AGC when combined with laparoscopic surgery.
  
  
  METHODS
  We compared the effects of perioperative XELOX (neoadjuvant chemotherapy group, NCG) with the effects of adjuvant XELOX (direct surgical group, DSG) in patients with locally AGC. The response to chemotherapy was assessed according to Recist criteria and pathological changes. The Kaplan-Meier log-rank test was used to calculate and compare survival differences.
  
  
  RESULTS
  Seventy patients were included (neoadjuvant=35). The rate of effective neoadjuvant chemotherapy was 62.9%, and the disease control rate was 91.5%. In the NCG, 32 (94.7%) of the patients underwent laparoscopic-assisted D2 radical gastrectomy. The R0 resection rate was 100%. However, rates were 26 (74.3%) and 85.7% in the DSG, respectively (P<0.05). The 3-year overall survival (OS) in the NCG was 77.1% vs. 62.3% in the DSG (P=0.119). The 3-year disease-free survival (DFS) was 74.3% in the NCG, and the DFS was 59.3% in the DSG (P=0.033).
  
  
  CONCLUSIONS
  XELOX can enhance the R0 resection rate, increase potential for laparoscopic surgery with rather good safety and improve the 3-year DFS of patients with AGC.
authors.forename: Chao-Hui
authors.initials: CH
authors.lastname: Zheng
authors.forename: Jun
authors.initials: J
authors.lastname: Lu
authors.forename: Chang-ming
authors.initials: CM
authors.lastname: Huang
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Xie
authors.forename: Jia-Bin
authors.initials: JB
authors.lastname: Wang
authors.forename: Jian-Xian
authors.initials: JX
authors.lastname: Lin
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D002681:China; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010071:Oxaloacetates; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D010071:Oxaloacetates; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil