DOF as neoadjuvant chemotherapy in the treatment of advanced gastric cancer

Objective: To explore the efficacy and safety of DOF as neoadjuvant chemotherapy in the treatment of advanced gastric cancer. Methods: From January 2005 to January 2008, 68 operable patients with stage II - III, IV ( M 0 ) gastric cancer in the General Surgery Department of Shandong Tumor Hospital received DOF as neoadjuvant chemotherapy before surgery. The regimens were as follows: 75 mg/m2 of IV docetaxel, IV drip for 2 h on d 1; 200 mg/m2 of calcium, IV drip before 5-fluorouracil ( 5-FU ) for 30 min; 400 mg/m2 of 5-FU, IV on d 1-2; 1200 mg/m2 of 5-FU, CIV for 46 h; and 75 mg/m2 of oxaliplatin, IV drip for 2 h on d2. The chemotherapy was repeated every 21 days. Efficacy was evaluated 21 days after three cycles. The patients then received surgery on days 21-28. Up to 68 cases of advanced gastric cancer that were not treated with neoadjuvant chemotherapy at the corresponding time period were designated as the controls and underwent surgery within two weeks. According to status of the patients and the principles of standard treatment for gastric cancer, they received postoperative chemotherapy. Results: In the chemotherapy group, there were 5 CR cases, 43 PR cases, 18 SD cases, and 1 PD case. The total effective rate was 70.6%. The most common side effects were granulocytopenia, gastrointestinal tract adverse reaction, and periphery neurotoxicity. The R0 resection rate was significantly higher than that in the control group (88.2% vs. 62.3% )( P= 0.01 ). There was no significant difference in the incidence of postoperative complications ( 2.9% vs. 1.5% ) between the two groups ( P= 0.559 ). The one-year survival rates of the two groups were both 100%. The two-year survival rate in the chemotherapy group was significantly higher than that in the control group ( 73.5% vs. 54.3% ) ( P= 0.013 ). Conclusion: The efficacy of DOF as neoadjuvant chemotherapy in the treatment of advanced gastric cancer is high. Patient tolerance and compliance are satisfactory. DOF can reduce the tumor size and tumor stage, as well as improve R0 resection rate and survival.