RESPONSE TO NEOADJUVANT CHEMOTHERAPY WITH FLOT FOR LOCALLY ADVANCED GASTRIC CANCER AT K HOSPITAL
Main Article Content
Abstract
Objectives: Describe the clinical and paraclinical characteristics of operable locally advanced gastric cancer and evaluate the response to neoadjuvant chemotherapy of gastric cancer with FLOT at K Hospital.
Methods: A descriptive study of a series of diseases was performed on 55 patients with locally advanced gastric cancer in the region with surgical ability (difficult prognosis) who were treated with neo-adjuvant chemotherapy FLOT at the K Hospital from January 2025 to March 2026.
Results: Median age was 58,4 ± 11,6, the male/female ratio was 2,23/1, overall status ECOG 0.1 accounted for 98.1%. Symptoms included epigastric pain (69.1%), bloating and indigestion (63,6), and weight loss (41.8%). The most common tumor location was the pyloric with 52.7%, followed by the body (27,4%). Ulcer type was the most common form, accounting for 36,4%, and mixed form of ulceration accounts for 30,9%. Evaluation of patients before treatment: 100% cT3-4, 78.2% had metastatic lymph nodes. The percentage of patients with clinical-symptom improvement was 94,6%. Clinical and histopathological response, the rate of complete response, partial response and unchanged was 9,1%, 60%, 30,9% and 0%, respectively. The ratio of cross section R0 reached 92,7%.
Conclusions: Neoadjuvant chemotherapy for patients with locally invasive gastric cancer using the FLOT regimen has shown promising results, including improved clinical symptoms, high response rates, easier surgery, and a high R0 resection margin.
Keywords
Neoadjuvant, gastric cancer, FLOT, response to treatment.
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References
2. Al-Batran, Homann N, Pauligk C, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet. 2019; 393(10184): p. 1948-1957.
3. Xiong, Y.Cheng, L.Ma, et al. An updated meta-analysis of randomized controlled trial assessing the effect of neoadjuvant chemotherapy in advanced gastric cancer.Cancer Invest. 2014; 32(6): p. 272-84.
4. Al-Batran, D.Hofheinz, C.Pauligk, et al. Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial. Lancet Oncol. 2016; 17(12): p. 1697-1708.
5. Z.Li, C. Koh, Z. Bu, et al. Neoadjuvant chemotherapy with FOLFOX: improved outcomes in Chinese patients with locally advanced gastric cancer. J Surg Oncol. 2012; 105(8): p. 793-9.
6. Cunningham, W.Allum, S.Stenning, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2016; 355(1): p. 11-20.
7. Schuhmacher, S. Gretschel, F.Lordick, et al. Neoadjuvant chemotherapy compared with surgery alone for locally advanced cancer of the stomach and cardia: European Organisation for Research and Treatment of Cancer randomized trial 40954. J Clin Oncol. 2010; 28(35): p. 5210-8.
8. Nguyễn Thi Hà, Phùng Thị Huyền, Đào Văn Tú. Kết quả bước đầu của phác đồ FLOT trong điều trị ung thư biểu mô dạ dày lan rộng tại chỗ. Tạp chí Y học Việt Nam. 2020; 494(2):p. 191-195.