Effectiveness of Neoadjuvant Chemotherapy With Docetaxel, Cisplatin, and S‐1 for Locoregionally Advanced Gastric Adenocarcinoma: Findings From a University Hospital in Vietnam
Year: 2025
Type: article
Study design: Observational Study
Abstract: ABSTRACT Aim To evaluate treatment results of a neoadjuvant regimen consisting of Docetaxel + Cisplatin + S‐1 (DCS) in patients with locoregionally advanced unresectable gastric adenocarcinoma characterized by tumors with bulky regional lymph nodes (T1–4a, N‐bulky, M0) or T4b tumors (any N, M0)). Methods This study included 78 patients with locoregionally advanced gastric adenocarcinoma treated at a university hospital in Vietnam, comprising 47 retrospective and 31 prospective cases. Patients received 2 ‐ 4 cycles of DCS chemotherapy, with each cycle comprising intravenous docetaxel (35 mg/m 2 ) and cisplatin (35 mg/m 2 ) on days 1 and 15, and oral S‐1 (40 mg/m 2 /twice daily) from days 1 to 14, repeated every 4 weeks. Clinical treatment response was assessed after every three cycles and re‐staging evaluation by using the RECIST criteria and contrast‐enhanced CT scans after 2 ‐ 4 cycles, depending on patient response and tolerability. Patients with a good response and down‐staging were referred for gastrectomy. Results The median age was 58 years, and 64.1% were male. Following neoadjuvant chemotherapy, the proportion of T4b tumors decreased from 78.2% to 52.6%, while T4a tumors increased from 20.5% to 43.6%. The rate of N‐bulky decreased from 23.1% to 11.5%. Anemia and neutropenia were the most common hematological toxicities, predominantly grade 1–2. Gastrointestinal toxicity and hair loss were the most frequent clinical adverse events, mostly grade 1–2. Among 65 patients (83.3%) achieving an objective response to neoadjuvant chemotherapy, 42 (53.8%) underwent gastrectomy, with R0 resection achieved in 92.9%. Conclusion Neoadjuvant chemotherapy using the DCS regimen every 4 weeks demonstrated high effectiveness and safety in patients with locoregionally advanced unresectable gastric adenocarcinoma characterized by extensive regional metastases, and increased their eligibility for successful gastrectomy (R0 resection). Trial Registration This study is a retrospective and prospective cohort study, not a clinical trial.
DOI: 10.1111/ajco.70039
Authors: Tho Vinh Tran, Truc Thanh Thai, Loi Ngoc La, Ngon Van Dinh, Vo Duy Long, Bac Hoang Nguyen
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4415428711