ASTRO Annual Meeting
MIAMI - A regimen of neoadjuvant paclitaxel and cisplatin followed by
surgery and post-operative chemoradiation with 5-FU and leucovorin did not
result in a high response rate and was too toxic for patients with gastric
Anuradha Bapsi Chakravarthy, MD, a radiation oncologist and
associate professor at Vanderbilt-Ingram Cancer Center, and colleagues enrolled
38 patients with resectable cancers of the stomach/GE junction from 1999 to
2002 into the phase 2 trial.
Patients received induction chemotherapy that consisted of paclitaxel
175 mg/m2 and cisplatin 75 mg/m2 every 21 days for three cycles. After surgery,
patients received 5-FU 425 mg/m2 and leucovorin 20 mg/m2 on days 1 through 5.
This was followed by chemoradiation, including 5-FU 400 mg/m2 and leucovorin 20
mg/m2 on weeks 1 and 5 of radiation. Finally, the chemoradiation was followed
by two additional cycles of 5-FU 425 mg/m2 and leucovorin 20 mg/m2 on days 1
through 5, every 28 days. The total radiation dose was 4,500 cGy.
Of the 38 patients, 35 completed all three cycles of induction therapy
and 29 of those went on to surgery. The response was assessed by pathology, and
was defined as complete response, progressive disease or stable disease. Of the
29 patients, 16 patients had stable disease, 10 progressed and three were
unevaluable. Of the 29 patients who had surgery, 19 of the patients were unable
to receive post-operative therapy due to either positive margins or
The majority of patients experienced grade-3 or grade-4 toxicity during
the induction therapy. Of the seven patients who received postoperative
therapy, six experienced grade-3 and grade-4 toxicity.
For more information:
- Chakravarty A. #131. Presented at: the 2011 ASTRO Annual Meeting;
Oct. 2-6, 2011; Miami Beach, Fla.