Bimonthly regimen of high-dose leucovorin, infusional 5-fluorouracil, docetaxel, and cisplatin (modified DCF) in advanced gastric adenocarcinoma. Gastric Cancer. 2013;16:428-434. [PMID: 23086560 DOI: 10.1007/s.10120-012-0206-x]

Efficacy of docetaxel plus S-1 as neoadjuvant chemotherapy for operable advanced gastric cancer

AIM: To evaluate the efficacy of preoperative chemotherapy with docetaxel plus S-1 (DS regimen) for resectable advanced gastric cancer.

METHODS: Two hundred and twenty patients with operable locally advanced gastric cancer were collected and equally divided into two groups (A and B). In group A, patients received docetaxel (35 mg/m²) on day 1 for 2 h and daily oral administration of S-1 [80 mg/(m²•d)] on days 1-14 every 4 wk for two cycles, and prophylactic administration of antiemetic medication at a standard doses was routinely used to prevent nausea and vomiting. Then gastrectomy with D2 lymphadenectomy was performed. In group B, patients received only gastrectomy with D2 lymphadenectomy. The R0 resection rate, pathological complete response (pCR), postoperative complications, local recurrence rate and survival rate were compared between the two groups.

RESULTS: Treatment-related death or operative mortality was not found in this study. Because of economic reasons, only 107 (97.3%) patients underwent surgery. There was no significant difference in the incidence of anastomotic leakage (1.8% vs 2.7%, P > 0.05) or poor healing of incision (5.6% vs 4.5%, P > 0.05). There were significant differences in R0 radical resection rate (99.06% vs 92.73%, P < 0.05), pCR rate (8.41% vs 1.81%, P < 0.05) and local recurrence rate (18.6% vs 31.8%, P < 0.05) between the two groups. The 3- (55.7% vs 40.6%, P < 0.05) and 5-year survival rates (31.3% vs 21.8%, P < 0.05) also differed significantly between the two groups.

CONCLUSION: DS regimen as neoadjuvant chemotherapy for operable locally advanced gastric cancer can increase the rates of R0 radical resection, pCR and survival, and decrease the recurrence rate, without increasing the rate of complications.