Effectiveness of neoadjuvant chemotherapy with a docetaxel, cisplatin, and S-1 (DCS) regimen for T4b gastric cancer

Abstract Background No studies on neoadjuvant chemotherapy for gastric cancer (GC) with T4b stage were reported. This study aimed to assess the effectiveness of neoadjuvant chemotherapy using DCS regimen (docetaxel, cisplatin, and S-1) for GC with T4b stage. Methods Forty-three patients diagnosed GC...

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Main Authors: Vo Duy Long, Dang Quang Thong, Tran Quang Dat, Doan Thuy Nguyen, Tran Duy Phuoc, Nguyen Viet Hai, Nguyen Lam Vuong, Lam Quoc Trung, Nguyen Hoang Bac
Format: Article
Language:English
Published: BMC 2024-12-01
Series:World Journal of Surgical Oncology
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Online Access:https://doi.org/10.1186/s12957-024-03620-1
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author Vo Duy Long
Dang Quang Thong
Tran Quang Dat
Doan Thuy Nguyen
Tran Duy Phuoc
Nguyen Viet Hai
Nguyen Lam Vuong
Lam Quoc Trung
Nguyen Hoang Bac
author_facet Vo Duy Long
Dang Quang Thong
Tran Quang Dat
Doan Thuy Nguyen
Tran Duy Phuoc
Nguyen Viet Hai
Nguyen Lam Vuong
Lam Quoc Trung
Nguyen Hoang Bac
author_sort Vo Duy Long
collection DOAJ
description Abstract Background No studies on neoadjuvant chemotherapy for gastric cancer (GC) with T4b stage were reported. This study aimed to assess the effectiveness of neoadjuvant chemotherapy using DCS regimen (docetaxel, cisplatin, and S-1) for GC with T4b stage. Methods Forty-three patients diagnosed GC with surgical or clinical T4b stage received three or four preoperative cycles of DCS therapy followed by gastrectomy and lymphadenectomy between Jan-2018 and Dec-2022. Short-tern outcomes including tumor response, completion of neoadjuvant chemotherapy, toxicity and adverse events, rate of treatment-related death, R0 resection, rate of complete adjuvant chemotherapy and short-term surgical results were investigated. The oncologic outcomes comprised 3-year OS and 3-year disease-free survival (DFS). Results A total of 43 patients with T4b gastric cancer were included in the analysis. Among them, twenty-five patients underwent gastrectomy and lymphadenectomy. The completion rate of neoadjuvant chemotherapy was 88.4%, including 4 cycles of 51.2% and 3 cycles of 37.2%. The disease-control and clinical response rate were 88.4% and 58.1%, respectively. During preoperative chemotherapy, grade 3/4 neutropenia occurred in 20.9%, anemia in 13.9%, hyponatremia in 4.8%, and vomiting in 2.3%. Pathologic complete response was achieved in 8.0%. After surgery, no patient experienced severe complications (Clavien Dindo > = 3). The R0 resection rate was 72.0% and the rate of complete adjuvant chemotherapy was 83.3%. The 3-year OS and DFS rates were 49% and 38%, respectively. Conclusions Neoadjuvant chemotherapy with DCS regimen demonstrated a high tolerance, high tumor response rate, high complete adjuvant chemotherapy rate and satisfactory 3-year survival outcomes. Three- or four-course of preoperative DCS regimen is a promising approach for GC with T4b stage.
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spelling doaj-art-0125b6ca59fc4a2eb0dd5aa9c550d1bb2025-08-20T02:39:49ZengBMCWorld Journal of Surgical Oncology1477-78192024-12-0122111110.1186/s12957-024-03620-1Effectiveness of neoadjuvant chemotherapy with a docetaxel, cisplatin, and S-1 (DCS) regimen for T4b gastric cancerVo Duy Long0Dang Quang Thong1Tran Quang Dat2Doan Thuy Nguyen3Tran Duy Phuoc4Nguyen Viet Hai5Nguyen Lam Vuong6Lam Quoc Trung7Nguyen Hoang Bac8Department of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Oncology, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh CityDepartment of Gastro-intestinal Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh CityAbstract Background No studies on neoadjuvant chemotherapy for gastric cancer (GC) with T4b stage were reported. This study aimed to assess the effectiveness of neoadjuvant chemotherapy using DCS regimen (docetaxel, cisplatin, and S-1) for GC with T4b stage. Methods Forty-three patients diagnosed GC with surgical or clinical T4b stage received three or four preoperative cycles of DCS therapy followed by gastrectomy and lymphadenectomy between Jan-2018 and Dec-2022. Short-tern outcomes including tumor response, completion of neoadjuvant chemotherapy, toxicity and adverse events, rate of treatment-related death, R0 resection, rate of complete adjuvant chemotherapy and short-term surgical results were investigated. The oncologic outcomes comprised 3-year OS and 3-year disease-free survival (DFS). Results A total of 43 patients with T4b gastric cancer were included in the analysis. Among them, twenty-five patients underwent gastrectomy and lymphadenectomy. The completion rate of neoadjuvant chemotherapy was 88.4%, including 4 cycles of 51.2% and 3 cycles of 37.2%. The disease-control and clinical response rate were 88.4% and 58.1%, respectively. During preoperative chemotherapy, grade 3/4 neutropenia occurred in 20.9%, anemia in 13.9%, hyponatremia in 4.8%, and vomiting in 2.3%. Pathologic complete response was achieved in 8.0%. After surgery, no patient experienced severe complications (Clavien Dindo > = 3). The R0 resection rate was 72.0% and the rate of complete adjuvant chemotherapy was 83.3%. The 3-year OS and DFS rates were 49% and 38%, respectively. Conclusions Neoadjuvant chemotherapy with DCS regimen demonstrated a high tolerance, high tumor response rate, high complete adjuvant chemotherapy rate and satisfactory 3-year survival outcomes. Three- or four-course of preoperative DCS regimen is a promising approach for GC with T4b stage.https://doi.org/10.1186/s12957-024-03620-1Gastric cancerNeoadjuvant chemotherapyT4b stageClinical response rateDCS regimen
spellingShingle Vo Duy Long
Dang Quang Thong
Tran Quang Dat
Doan Thuy Nguyen
Tran Duy Phuoc
Nguyen Viet Hai
Nguyen Lam Vuong
Lam Quoc Trung
Nguyen Hoang Bac
Effectiveness of neoadjuvant chemotherapy with a docetaxel, cisplatin, and S-1 (DCS) regimen for T4b gastric cancer
World Journal of Surgical Oncology
Gastric cancer
Neoadjuvant chemotherapy
T4b stage
Clinical response rate
DCS regimen
title Effectiveness of neoadjuvant chemotherapy with a docetaxel, cisplatin, and S-1 (DCS) regimen for T4b gastric cancer
title_full Effectiveness of neoadjuvant chemotherapy with a docetaxel, cisplatin, and S-1 (DCS) regimen for T4b gastric cancer
title_fullStr Effectiveness of neoadjuvant chemotherapy with a docetaxel, cisplatin, and S-1 (DCS) regimen for T4b gastric cancer
title_full_unstemmed Effectiveness of neoadjuvant chemotherapy with a docetaxel, cisplatin, and S-1 (DCS) regimen for T4b gastric cancer
title_short Effectiveness of neoadjuvant chemotherapy with a docetaxel, cisplatin, and S-1 (DCS) regimen for T4b gastric cancer
title_sort effectiveness of neoadjuvant chemotherapy with a docetaxel cisplatin and s 1 dcs regimen for t4b gastric cancer
topic Gastric cancer
Neoadjuvant chemotherapy
T4b stage
Clinical response rate
DCS regimen
url https://doi.org/10.1186/s12957-024-03620-1
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