Neoadjuvant Chemotherapy Within Combined Treatment Gastric Cancer Patients, Evaluation of Effectiveness

Abstract

Background: The gastric cancer (GC), despite a steady decline in the incidence, is one of the most common malignancies in Ukraine and in other countries around the world. The major treatment strategy during the last decades has been postoperative systemic therapy. The results of published trials were reviewed. And neoadjuvant chemotherapy (CRT) was evaluated. Method(s): Patients with GC (n = 55) randomly underwent neoadjuvant CRT (PELF) followed by planned surgical resection, group A (n = 34) or surgery alone, group B (n = 40) at clinic of National Cancer Institute of Ukraine, between 2009 and 2013. Overall survival (OS), local control (LC) and biological markers were estimated. Result(s): Correlations between expression levels of molecular marker VEGFR-1 and gastric cancer tumor cells sensitivity were found. It was no differences in 2-year overall survival rates (64% vs 56.6% for groups A and respectively, p = 0.22). Primary tumor volumetry showed difference between the average value before and after neoadjuvant CRT, 182 +/- 11.4 mm3 vs 112 +/- 8.7 mm3, p < 0.001. Conclusion(s): Performed analysis is an evidence of urgency and practical importance of the modern molecular technologies application for the purpose of stomach cancer patients treatment algorithms improvement. It was proved sensitivity for VEGFR-1 to chemotherapy in patients with GC. Determination of sensitivity to neoadjuvant CRT offers the prospect of achieving a reasonable treatment in patients with GC and reducing the overall cost of treatment.