Published online Dec 28, 2014. doi: 10.3748/wjg.v20.i48.18413
Revised: September 15, 2014
Accepted: October 21, 2014
Published online: December 28, 2014
Processing time: 303 Days and 23 Hours
AIM: To investigate the clinical efficacy and toxic effects of neoadjuvant chemotherapy using docetaxel combined with oxaliplatin and fluorouracil for treating stage III/IV gastric cancer.
METHODS: A total of 53 stage III/IV gastric cancer patients were enrolled into the study and treated with neoadjuvant chemotherapy. Two of the cases were excluded. The program was as follows: 75 mg/m2 docetaxel and 85 mg/m2 oxaliplatin on day 1 and 1500 mg/m2 fluorouracil on days 1 to 3 for three weeks.
RESULTS: The tumour changes, postoperative remission rate, changes in the symptoms and adverse reactions were observed. The overall clinical efficacy (complete remission + partial remission) of the neoadjuvant chemotherapy was 62.7%. R0 radical resection was performed on 60.8% of the patients, with a remission rate (pathological complete response + pathological subtotal response + pathological partial response) of 74.2%. The Karnofksy score improved in 42 cases. The toxicity reactions mostly included myelosuppression, followed by gastrointestinal mucosal lesions, nausea, vomiting and diarrhoea.
CONCLUSION: Neoadjuvant chemotherapy consisting of docetaxel combined with oxaliplatin and fluorouracil is effective for stage III/IV gastric cancer. However, the treatment is associated with a high incidence of bone marrow suppression, which should be managed clinically.
Core tip: This study analysed the combination of docetaxel, oxaliplatin and fluorouracil in the neoadjuvant chemotherapy towards stage III/IV gastric cancer patients, and observed the changes of tumours after chemotherapy, as well as the surgical resection rate, postoperative pathological remission degree, clinical symptom remission degree and adverse reactions, aiming to verify the effectiveness and safety of this regimen in clinical applications.