[A prospective study of FOLFOX7 scheme as neoadjuvant chemotherapy for stage III gastric adenocarcinoma]

To evaluate the efficacy and safety of FOLFOX7 scheme as neoadjuvant chemotherapy in patients with stage III gastric adenocarcinoma.

From May 2005 to May 2007, 27 patients with stage III gastric adenocarcinoma were given neoadjuvant chemotherapy with FOLFOX7 scheme. Gastroscopy, endoscopic ultrasonography, abdominal B ultrasonography and abdominal CT was taken before chemotherapy and after 2 - 4 cycles of neoadjuvant chemotherapy to evaluate the objective response rate of the tumor. Then operations were carried out and the pathological responses was evaluated in those cases. The safety, objective response rate and pathological rate of neoadjuvant chemotherapy was assessed according to NCI-CTC v3.0, RECIST 2000, and the criteria established by Japanese Research Society for Gastric Cancer, respectively. R0 resection rate and surgery-related complications was also assessed in this group.

The treatment was well tolerated, no grade 3 - 5 toxicity was observed. Complete response was obtained in 1 case, and partial response in 18 patients, overall response rate was 70.4% (19/27). Twenty-six patients received operation and R0 resection rate was 88.4% (23/26); no patient died in the perioperative period. The pathological response rate of patients had R0 excision was 60.9% (14/23).

FOLFOX7 scheme as neoadjuvant chemotherapy for selected patients with stage III gastric adenocarcinoma can be well tolerated, it could induce tumor down-staging and improve R0 resection rate, although the long term efficacy remains to be evaluated.