To identify clinicopathologic and treatment variables that could predict pathologic
tumor response to short-term
neoadjuvant chemotherapy (NAC) for patients with locally advanced
gastric cancer. A retrospective analysis was conducted of 178 patients who underwent short-term NAC with EOX regimen followed by surgery from January 2008 to December 2010.
Neoadjuvant treatment response was evaluated using
tumor regression grade. Relationships between pathologic
tumor response and clinicopathological factors were evaluated using logistic regression analysis. The benefits of
regional arterial infusion chemotherapy were investigated separately. The postoperative pathological response rate was 46.1% (82/178) and 4 patients (2.2%) had complete pathological remission. Pathological response was significantly associated with
tumor differentiation (P = 0.008), abnormal a-
fetoprotein levels (P = 0.01) and administration approach to
chemotherapy (intravenous versus
regional arterial infusion chemotherapy) (P = 0.018). Most bone marrow toxicities,
vomiting,
nausea,
alopecia, and
fatigue were acceptable. Grade 3/4 toxicities were not commonly observed. The 3-year overall survival (OS) and recurrence free survival (RFS) were 67.0% and 53.0%, respectively.
Regional arterial infusion NAC group had significantly better median RFS (48.0 versus 34.0 months) than the intravenous NAC group (P = 0.049). In conclusion,
regional arterial infusion NAC can improve the pathological response rate of advanced
gastric cancer treated with EOX regimen.