Author(s)

Shimaa Ahmed¹, Mayada Fawzy², Khalid Rezk^3*, Wessam Elshrif⁴, Mohamed Alaa⁵, Mohamed M. H. Abd Ellah⁶

¹Radiation Oncology, South Egypt Cancer Institute, Assuit University, Assiut, Egypt.
²Medical Oncology, South Egypt Cancer Institute, Assuit University, Assiut, Egypt.
³Surgical Oncology, South Egypt Cancer Institute, Assuit University, Assiut, Egypt.
⁴Clinical Oncology, Cairo University, Cairo, Egypt.
⁵Clinical Oncology, Assuit University, Assiut, Egypt.
⁶Diagnostic Radiology, South Egypt Cancer Institute, Assuit University, Assiut, Egypt.

Background and objectives: Surgery is the primary therapy for localized gastric cancer, but even with the best results only 40% 5-year survival can be achieved with the use of postoperative adjuvant chemoradiotherapy. Preoperative therapy might help increase the R0 resection rate, which is an independent predictor of 5-year OS. Our study hypothesized that the concurrent combination of carboplatin-paclitaxel with radiation therapy would result in a pathological CR rate, which will be in turn associated with OAS and DFS benefits. Patients and methods: prospective phase II study included 32 patients with locally advanced gastric adenocarcinoma including gastroesophageal junction who received a combination of neoadjuvant conformal radiotherapy concurrently with carboplatin-paclitaxel followed by surgery. Results: Pathological CR and R0 resection rates were 18.8% and 75% respectively. With a median follow up of 24 months, 2 years disease-free survival was 28.1% and overall survival was 51.3%. The regimen was tolerated with neither grade 4 toxicities nor deaths. Conclusion: Neoadjuvant radiotherapy concomitant with carboplatin-paclitaxel chemotherapy is a well-tolerated approach for patients with locally advanced gastric adenocarcinoma resulting in significant pathological CR and R0 resection margins as reflected by the good DFS and OS.

Gastric Adenocarcinoma, Neoadjuvant, Paclitaxel-Carboplatin, Chemoradiotherapy, Pathologicalcr-R0

Ahmed, S. , Fawzy, M. , Rezk, K. , Elshrif, W. , Alaa, M. and Ellah, M. (2018) Preoperative Conformal Radiotherapy Concurrently with Paclitaxel/Carboplatin in Gastric Cancer. Journal of Cancer Therapy, 9, 503-515. doi: 10.4236/jct.2018.96041.