title: FOLFOX as Perioperative Chemotherapy of localized Gastric Cancer: Efficacy and Tolerance.
abstract: BACKGROUND
  Use of perioperative chemotherapy had significantly improved prognosis of localized gastric cancer. Two studies have validated this approach using cisplatin based chemotherapy despite important toxicities. We conducted this study with the aim to evaluate efficacy and toxicity of FOLFOX regimen in this setting.
  
  
  METHODS
  This is a retrospective study including patients followed for gastric cancer in the Oncology Department of the military hospital Mohamed V in Rabat, Morocco over a period of 7 years from 2007 to 2013. Patients received 4 cycles of mFOLFOX as perioperative regimen. Assessment of tumor response after completion of preoperative chemotherapy was granted by comparative CT scan, tumor markers measurements and R0 surgery rate.Adverse events were graded according to classification of the National Cancer Institute Common Toxicity Criteria version 4.0.
  
  
  RESULTS
  Thirty-one patients were included in this study. Use of preoperative chemotherapy showed partial response in fourteen patients (45.1%), stabilization in fifteen patients (48.4%). Tumor markers CEA and CA 19- 9 were significantly decreased. R0 resection rate was 83.87%. Only 2 (6.45%) cases of grade 3/4 hematologic toxicity were reported in our study. Achieving programmed postoperative chemotherapy was possible in 72.41% of patients.
  
  
  CONCLUSIONS
  Our study is limited by the retrospective design and small sample size but FOLFOX chemotherapy seems effective and well tolerated in this setting and its place deserves to be studied in a larger study.
authors.affiliation: Department of Medical Oncology Academic Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: R
authors.initials: R
authors.lastname: Tanz
authors.affiliation: Department of Medical Oncology Academic Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: C
authors.initials: C
authors.lastname: El Mhadi
authors.affiliation: Department of Medical Oncology Academic Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Toreis
authors.affiliation: Department of Medical Oncology Academic Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: M R
authors.initials: MR
authors.lastname: Khmamouch
authors.affiliation: Department of Medical Oncology Academic Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: T
authors.initials: T
authors.lastname: Mahfoud
authors.affiliation: Department of Surgery, Academic Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: A A
authors.initials: AA
authors.lastname: Ali
authors.affiliation: National Institute of Oncology, Rabat, Morocco.
authors.forename: H
authors.initials: H
authors.lastname: Errihani
authors.affiliation: Department of Medical Oncology Academic Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Ichou
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D013505:Digestive System Surgical Procedures; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D002955:Leucovorin / Q000009:adverse effects / Q000627:therapeutic use; D009944:Organoplatinum Compounds / Q000009:adverse effects / Q000627:therapeutic use; D019990:Perioperative Care; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil
keywords: FOLFOX; efficacy; gastric cancer; perioperative chemotherapy; toxicity.