Adjuvant chemoradiotherapy is the optimal management strategy in resectable gastric cancer. There is a debate about the efficacy of more aggressive CRT plus chemotherapy regimens in adjuvant setting. This study aimed to compare the efficacy of adjuvant CRT plus DCF versus CRT plus FUFA in stage III gastric cancer.
Patients with a diagnosis of stage III gastric cancer, treated with adjuvant therapy after curative resection were analyzed. Patients' and disease characteristics, impacts of the regimen on median progression free survival (mPFS) and median overall survival (mOS) were analyzed retrospectively. DCF arm had been treated with 2 cycles DCF (docetaxel 75mg/m2, cisplatin 75mg/m2 on day 1, fluorouracil 750mg/m2 for 4 days every 3 weeks) followed by concurrent CRT with 2 cycles of FUFA (fluorouracil 425mg/m2, folinic acid 20mg/m2, 3 days) and 2 cycles of DCF. FUFA arm was treated with Macdonald regimen (1 cycle of FUFA for 5 days, followed by CRT with 2 cycles of FUFA and further 2 cycles of FUFA.
140 gastric cancer patients, 94 in FUFA and 46 in DCF arms, were evaluated. Patient and disease characteristics were similar between groups. There were more renal toxicity (40% v 7%, p
There is no DFS or OS advantage of CRT plus DCF over CRT plus FUFA. More aggressive adjuvant therapy with CRT plus DCF is also more toxic than Macdonald regimen.
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All authors have declared no conflicts of interest.