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Abstract
Introduction. In this paper we present the frequency of pathological response after 2 cycles of neoadjuvant chemotherapy followed by chemoradiotherapy and radical surgery in patients with locally advanced gastric cancer.
Materials and Methods. Between 2018 and 2022 a prospective phase II clinical trial was conducted at the A. Tsyb MRRC. Patients were treated with 2 cycles of chemotherapy (FLOT) followed by chemoradiotherapy to a total dose of 46 Gy with concurrent chemotherapy containing capecitabine (1850 mg/m2 per day) and oxaliplatin (85 mg/m2 on the 1st and 22nd day of radiotherapy), followed by a control assessment after 5-7 weeks and surgical treatment.
Results. The trial included 47 patients with locally advanced gastric cancer aged between 40 and 75 years (median — 61 years). There were 26 (55.3 %) males. The most common location of the tumor was in the upper third of the stomach (19 patients); in 9 cases there was a spread to the esophagus. The most frequent histological type was adenocarcinoma G3 (49 %). Metastatic lymph nodes were present in 27 (57.4 %) patients. Radical surgical treatment was possible in 93.6 % (44/47) of the cases. Expressed tumor regression (grade Ia and Ib according to K. Becker classification) was observed in 66 % of patients, including complete morphological regression of the primary tumor and metastatic lymph nodes (grade 1a) in 7 (16 %) cases. No clinical factors significantly influenced the degree of regression. There was a statistically significant predominance of less advanced tumors (according to ypT category and stage) in patients with a major tumor response.
Conclusion. Pathological tumor response (grade 1a and 1b according to Becker) of patients who received multimodal neoadjuvant therapy was 66 % (29/44). According to the literature, these patients are classified as 'responders' and have a more favorable prognosis.
References
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