Background and objectives: Surgery is the primary therapy for localized gastric
cancer, but even with the best results only 40% 5-year survival can be
achieved with the use of postoperative adjuvant chemoradiotherapy. Preoperative
therapy might help increase the R0 resection rate, which is an independent
predictor of 5-year OS. Our study hypothesized that the concurrent
combination of carboplatin-paclitaxel with radiation therapy would result in a
pathological CR rate, which will be in turn associated with OAS and DFS benefits.
Patients and methods: prospective phase II study included 32 patients
with locally advanced gastric adenocarcinoma including gastroesophageal
junction who received a combination of neoadjuvant conformal radiotherapy
concurrently with carboplatin-paclitaxel followed by surgery. Results: Pathological
CR and R0 resection rates were 18.8% and 75% respectively. With a
median follow up of 24 months, 2 years disease-free survival was 28.1% and
overall survival was 51.3%. The regimen was tolerated with neither grade 4
toxicities nor deaths. Conclusion: Neoadjuvant radiotherapy concomitant
with carboplatin-paclitaxel chemotherapy is a well-tolerated approach for patients
with locally advanced gastric adenocarcinoma resulting in significant
pathological CR and R0 resection margins as reflected by the good DFS and
OS.