FOLFOX versus EOX as a neoadjuvant chemotherapy regimen for patients with advanced gastric cancer

Chen,Wenjun; Shen,Jianguo; Pan,Tao; Hu,Wenxian; Jiang,Zinong; Yuan,Xiaoming; Wang,Linbo

doi:10.3892/etm.2013.1449

FOLFOX versus EOX as a neoadjuvant chemotherapy regimen for patients with advanced gastric cancer

Authors:
- Wenjun Chen
- Jianguo Shen
- Tao Pan
- Wenxian Hu
- Zinong Jiang
- Xiaoming Yuan
- Linbo Wang
View Affiliations

Affiliations: Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310016, P.R. China, Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang 310016, P.R. China
Published online on: December 13, 2013 https://doi.org/10.3892/etm.2013.1449
Pages: 461-467

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Neoadjuvant chemotherapy is the preferred treatment of advanced gastric cancer. However, the choice of an optimal regimen remains controversial. The present study aimed to assess the effectiveness of preoperative chemotherapy with EOX and FOLFOX in Chinese patients with advanced gastric cancer. A total of 87 and 26 patients underwent FOLFOX and EOX regimens, respectively, for advanced gastric cancer between July 2004 and September 2012. Clinicopathological characteristics, pathological T stage, N stage and pathological response to tumour regression were retrospectively compared between the two groups. Following neoadjuvant chemotherapy, a higher number of patients manifested deeper invasive cancer in the FOLFOX group than those in the EOX group (P=0.047). In addition, a higher number of patients also exhibited metastatic lymph nodes in the FOLFOX group (67.8%) than in the EOX group (57.7%) (P=0.000). In the FOLFOX and EOX groups, 4 (4.6%) and 3 (11.5%) cases of complete regression were observed, respectively. A higher number of patients (38.5%) also exhibited tumour regression grades of 3 and 4 in the EOX group than in the FOLFOX group (19.5%) (P=0.047). Results of the present study suggest that the EOX regimen may be more effective than the FOLFOX regimen as preoperative chemotherapy for Chinese patients with advanced gastric cancer. The EOX regimen may be suitable for younger patients subjected to individual neoadjuvant chemotherapy.

View Figures

View References

1	Jemal A, Bray F, Center MM, Ferlay J, Ward E and Forman D: Global cancer statistics. CA Cancer J Clin. 61:69–90. 2011. View Article : Google Scholar
2	Jemal A, Siegel R, Xu J and Ward E: Cancer statistics, 2010. CA Cancer J Clin. 60:277–300. 2010. View Article : Google Scholar
3	Sasako M: Principles of surgical treatment for curable gastric cancer. J Clin Oncol. 21:S274–S275. 2003. View Article : Google Scholar
4	Cunningham D, Allum WH, Stenning SP, et al: Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 355:11–20. 2006. View Article : Google Scholar : PubMed/NCBI
5	Ott K, Lordick F, Herrmann K, Krause BJ, Schuhmacher C and Siewert JR: The new credo: induction chemotherapy in locally advanced gastric cancer: consequences for surgical strategies. Gastric Cancer. 11:1–9. 2008. View Article : Google Scholar : PubMed/NCBI
6	Wang LB, Shen JG, Xu CY, Chen WJ, Song XY and Yuan XM: Neoadjuvant chemotherapy versus surgery alone for locally advanced gastric cancer: a retrospective comparative study. Hepatogastroenterology. 55:1895–1898. 2008.PubMed/NCBI
7	Zhang J, Chen RX, Zhang J, et al: Efficacy and safety of neoadjuvant chemotherapy with modified FOLFOX7 regimen on the treatment of advanced gastric cancer. Chin Med J (Engl). 125:2144–2150. 2012.PubMed/NCBI
8	Eisenhauer EA, Therasse P, Bogaerts J, et al: New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 45:228–247. 2009. View Article : Google Scholar
9	Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 14:113–123. 2011. View Article : Google Scholar : PubMed/NCBI
10	Lowy AM, Mansfield PF, Leach SD, Pazdur R, Dumas P and Ajani JA: Response to neoadjuvant chemotherapy best predicts survival after curative resection of gastric cancer. Ann Surg. 229:303–308. 1999. View Article : Google Scholar : PubMed/NCBI
11	Becker K, Mueller JD, Schulmacher C, et al: Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy. Cancer. 98:1521–1530. 2003. View Article : Google Scholar : PubMed/NCBI
12	Mansour JC, Tang L, Shah M, et al: Does graded histologic response after neoadjuvant chemotherapy predict survival for completely resected gastric cancer? Ann Surg Oncol. 14:3412–3418. 2007. View Article : Google Scholar
13	Mandard AM, Dalibard F, Mandard JC, et al: Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations. Cancer. 73:2680–2686. 1994. View Article : Google Scholar
14	Beddy D, Hyland JM, Winter DC, et al: A simplified tumor regression grade correlates with survival in locally advanced rectal carcinoma treated with neoadjuvant chemoradiotherapy. Ann Surg Oncol. 15:3471–3477. 2008. View Article : Google Scholar
15	Wang LB, Teng RY, Jiang ZN, et al: Clinicopathologic variables predicting tumor response to neoadjuvant chemotherapy in patients with locally advanced gastric cancer. J Surg Oncol. 105:293–296. 2012. View Article : Google Scholar : PubMed/NCBI
16	Trotti A, Colevas AD, Setser A, et al: CTCAE v3.0: Development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol. 13:176–181. 2003. View Article : Google Scholar : PubMed/NCBI
17	Robb WB and Mariette C: Predicting the response to chemotherapy in gastric adenocarcinoma: who benefits from neoadjuvant chemotherapy? Recent Results Cancer Res. 196:241–268. 2012. View Article : Google Scholar : PubMed/NCBI
18	Hundahl SA, Menck HR, Mansour EG and Winchester DP: The National Cancer Data Base report on gastric carcinoma. Cancer. 80:2333–2341. 1997. View Article : Google Scholar : PubMed/NCBI
19	Ychou M, Boige V, Pignon JP, et al: Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol. 29:1715–1721. 2011. View Article : Google Scholar
20	Boige V, Pignon J, Saint-Aubert B, et al: Final results of a randomized trial comparing preoperative 5-fluorouracil/cisplatin to surgery alone in adenocarcinoma of stomach and lower esophagus (ASLE): FNLCC ACCORD07-FFCD 9703 trial (abstract). J Clin Oncol. 25:200s2007.
21	Schuhmacher C, Gretschel S, Lordick F, 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. 28:5210–5218. 2010. View Article : Google Scholar
22	Persiani R, D’Ugo D, Rausei S, et al: Prognostic indicators in locally advanced gastric cancer (LAGC) treated with preoperative chemotherapy and D2-gastrectomy. J Surg Oncol. 89:227–236. 2005. View Article : Google Scholar : PubMed/NCBI
23	Moon H, JFJ, Wu AW, et al: Oxaliplatin plus 5-fuorouracil/leueovorin (FOLFOX7) as neoadjuvant plus adjuvant treatment versus adjuvant alone in locally advanced resectable gastric cancer: BJSA-01 study design and interim results. In: Gastro-intestinal Cancers Symposium; Abstract No 39. 2007
24	Cunningham D, Starling N, Rao S, et al: Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med. 358:36–46. 2008. View Article : Google Scholar : PubMed/NCBI
25	Brown WA, Thomas J, Gotley D, et al: Use of oesophagogastroscopy to assess the response of oesophageal carcinoma to neoadjuvant therapy. Br J Surg. 91:199–204. 2004. View Article : Google Scholar : PubMed/NCBI
26	Ge L, Wang HJ, Yin D, et al: Effectiveness of 5-flurouracil-based neoadjuvant chemotherapy in locally-advanced gastric/gastroesophageal cancer: a meta-analysis. World J Gastroenterol. 18:7384–7393. 2012. View Article : Google Scholar : PubMed/NCBI
27	Liao Y, Yang ZL, Peng JS, Xiang J and Wang JP: Neoadjuvant chemotherapy for gastric cancer: a meta-analysis of randomized, controlled trials. J Gastroenterol Hepatol. 28:777–782. 2013. View Article : Google Scholar : PubMed/NCBI