Objective: To investigate the efficacy and safety of S-1 combined with oxaliplatin (SOX regimen) as neoadjuvant chemotherapy for advanced gastric cancer.
Methods: From November 2009 to September 2010, 66 patients with advanced gastric cancer were enrolled in this study. Thirty-two patients were given preoperative chemotherapy using SOX regimen. S-1 was administered orally 80 mg·(m(2))(-1)·d(-1) for 14 days, while oxaliplatin(130 mg/m(2)) was administered intravenously on day 1. The treatment was repeated every 3 weeks. The efficacy and safety were assessed every 2 cycles of chemotherapy. The other 34 patients were in control group. R0 resection rate and D2 lymph nodes dissection rate were analyzed for all surgical patients.
Results: The overall response rate of neoadjuvant chemotherapy was 68.8% and disease control rate was 93.8%. Grade 3/4 hematological toxicities were liver dysfunction(9.4%), anemia(6.3%) and neutropenia(6.3%), and non-hematological toxicities included vomiting(12.5%) and anorexia(5.7%). Thirty-two patients after neoadjuvant chemotherapy underwent surgical resection, of whom 25 patients(78.1%) received D2 lymph nodes dissection and the R0 resection rate was 81.3%,higher than those in control group(D2 lymph nodes dissection rate:67.6%,P =0.028; R0 resection rate:73.5%,P =0.040).
Conclusion: SOX regimen as neoadjuvant chemotherapy is associated with high efficacy, acceptable adverse effect, and increased rate of D2 lymph nodes dissection and R0 resection.