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Neoadjuvant chemotherapy and ongoing-trials.

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Preoperative chemotherapy and chemoradiotherapy for gastric cancer are increasingly effective. Neoadjuvant treatment for locally advanced gastric cancer is now considered Level I evidence, improving curative surgery rates.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Gastric carcinoma treatment has evolved significantly.
  • Preoperative therapy aims to improve surgical outcomes and patient safety.

Purpose of the Study:

  • To outline the history of preoperative therapy for gastric carcinoma.
  • To demonstrate the safety and efficacy of neoadjuvant treatments.

Main Methods:

  • Literature review of studies on preoperative chemotherapy, radiotherapy, and chemoradiotherapy for gastric cancer.
  • Searches conducted on PubMed for English-language papers published between 1970 and 2010.

Main Results:

  • Therapeutic approaches have advanced from induction chemotherapy for unresectable disease to neoadjuvant therapy for resectable gastric neoplasms.
  • Phase III trials demonstrate the progression of neoadjuvant strategies.

Conclusions:

  • Preoperative chemotherapy in multimodal treatment for gastric adenocarcinoma is encouraging.
  • Neoadjuvant chemotherapy for locally advanced, resectable gastric cancer is supported by Level I evidence, enhancing the likelihood of curative R0 resection.