NEW NEOADJUVANT TREATMENT STRATEGIES FOR GASTRIC AND GASTROESOPHAGEAL JUNCTION CANCERS

Authors : Serdar Turhal, Howard Bruckner

Pages : 20-24

View : 11 | Download : 9

Publication Date : 2016-12-03

Article Type : Research Paper

Abstract :Objective: The feasibility of neoadjuvant chemotherapy for clinically unresectable gastric and gastroesophageal insert ignore into journalissuearticles values(GE); junction cancers. Methods: Eleven patients with gastric and GE junction cancers underwent preoperative combined modality chemo and radiotherapy and a subsequent attempt for surgical resection. Results: Combined modality periadjuvant therapies downsized 9 of 11 T3-4 gastric and gastroesophageal junction cancers and produced 4 pathologically proven complete remissions. Treatment appeared to convert lymph nodes to a cancer free status for 7 of 11 patients. After treatment, exploratory surgery found that 3 patients had only minute foci of occult metastatic disease. The quality of the responses was underestimated by both endoscopic ultrasound and CT scans. Responses were sometimes only achieved after 2-3 months of therapy. Conclusion: Combined modality therapy demonstrates the feasibility of a flexible multistep approach to neoadjuvant therapy incorporating new drugs such as methotrexate and hydroxyurea in addition to fluorouracil and cisplatin. Long delays in surgery insert ignore into journalissuearticles values(gastrectomy); appear to be safe in the context of combined modality therapy. Median survival exceeds 2 years. The experience suggests new early end points for evaluation of neoadjuvant treatments: quality of life, quality of lymph node sterilization and extent of required gastrectomy in comparison to standard surgery. Key Words: Neoadjuvant, Gastric cancer, Gastroesophageal cancer, Combined modality treatment
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