A pilot study of an individualized comprehensive treatment for advanced gastric cancer with para-aortic lymph node metastasis

Background:
The incidence of the para-aortic lymph node metastasis (PALM) in patients with advanced gastric cancer is 6 to 33 %. The prognosis is poor and the 5-year survival rate is only 12 to 23 % after gastrectomy with super-extended lymph node dissection. We applied an individualized comprehensive treatment for affected patients including neoadjuvant chemotherapy via intra-arterial and intravenous administration, surgery and radiotherapy, to investigate the safety and prognostic value.
Methods:
Between January 2005 and December 2010, 47 advanced gastric cancer patients with PALM received 5-Fu (370 mg/m
2
) and leucovorin (200 mg/m
2
) intravenously on days 1–5, and intra-arterial infusion of etoposide (80 mg/m
2
) and oxaliplatin (80 mg/m
2
) on days 6 and 20, repeated 2 cycles. Patients achieved PR or CR of the para-aortic lymph node (PAL) were performed D2 dissection, followed by 6 cycles chemotherapy with XELOX regimen, oxaliplatin (130 mg/m
2
) on day 1 and xeloda (1000 mg/m
2
) on days 1 to 14 of a 28-day cycle, and radiotherapy to the region of PALM.
Results:
Forty-six patients completed 2 cycles of neoadjuvant chemotherapy. The overall response rate of the primary tumor was 80.4 % (37/46). The response rate of...

Source: Epidemiologic Perspectives and Innovations - January 18, 2016 Category: Epidemiology Authors: Qi HeLong MaYang LiGuoli Li Source Type: research