Neo Adjuvant Chemotherapy in Locally Advanced Gastric Cancers of The Medical Oncology Department of The Hospital University of Blida (Algeria)

Melzi, M. A.; Idir, H.; Bouzidi, W.; Bounedjar, A.
June 2016
Pan Arab Journal of Oncology;Jun2016, Vol. 9 Issue 2, p35
Academic Journal
Introduction: Gastric cancer is commonly diagnosed at locally advanced stage, with unresectable tumors. The use of neo adjuvant chemotherapy may lead to tumor down staging with possibilities of a surgical resection. We will evaluate in this study the efficacy and the safety of the neo adjuvant chemotherapy in locally advanced gastric cancers, treated at the Medical Oncology Department of the University Hospital of Blida (Algeria). Methods: A retrospective study on patients with a locally advanced gastric cancer received neo adjuvant chemotherapy at the Medical Oncology Department of the University Hospital of Blida (Algeria), from 2014 to 2015). Results: Sixteen patients (16) were enrolled, with a mean age of 62.5 ± 6.69 years, and a sex ratio of 7 (14 men/2 women). The mean weight was 56.4 ± 5.38 kilograms, with a mean body mass index (BMI) of 21.02 ± 1.51. The main symptoms were stomachache and weight loss, found in 68.75% of patients, followed by dysphagia (40%) and vomiting (31.25%). Adenocarcinoma was the most found histological type (75% of patients). Tumor of the esophagogastric junction was found in 18.75% of patients. The average tumor thickness was 31 ± 11.3 mm, and the average tumor extent was 63.4 ± 13.9 mm. All the patients received neoadjuvant chemotherapy. XELOX regimen (Oxaliplatin 130 mg/m? intravenous infusion day 1 combined with Capecitabine 1000 mg/m? BID from day 1 to day 14; 21 days cycles) was given to 62.5% of the patients, XP regimens (Cisplatin 75 mg/m? intravenous infusion day 1 or Carboplatin AUC5 intravenous infusion day 1combined with Capecitabine 1000 mg/m? BID from day 1 to day 14; 21 days cycles) was given to 25% of the patients. After an average of 4.18 ± 0.31 cycles, the most observed grade 3/4 hematological toxicities were neutropenia (6.25% of patients) and thrombocytopenia (6.25%), for non-hematological toxicities, the hand and foot syndrome was the only found, observed in 6.25% of patients. 68.75% of the patients were evaluable. The evaluation found a control disease in 81.81% of patients, including a complete remission (9.09%), a partial remission (63.63%) and a stable disease in 9.09%); a progressive disease was found in 18.18% of patients. 50% of the patients of the study underwent a surgery after the neo adjuvant treatment, which was R0 in 50% of them. Conclusion: Neoadjuvant chemotherapy in locally advanced gastric cancer is a therapeutic option that allows obtaining respectability. The use of a Capecitabine combined with paltinium (Oxaliplatin, Cisplatine or Carboplatine) allowed surgery in 50% of patients, with an R0 resection in 25% of the study population.


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