PERIOPERATIVE CHEMOTHERAPY IN LOCALLY ADVANCED GASTRIC CANCER

BATISTA, Thales Paulo; SANTOS, Candice Amorim de Araújo Lima; ALMEIDA, Gustavo Fernandes Godoy

doi:10.1590/S0004-28032013000200042

Acessibilidade / Reportar erro

Brasil

Arquivos de Gastroenterologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Review • Arq. Gastroenterol. 50 (3) • July-Sept 2013 • https://doi.org/10.1590/S0004-28032013000200042 copy

PERIOPERATIVE CHEMOTHERAPY IN LOCALLY ADVANCED GASTRIC CANCER

Quimioterapia peri-operatória no tratamento do câncer gástrico localmente avançado

Authorship SCIMAGO INSTITUTIONS RANKINGS

Gastric cancer is one of the most common cancers and a main cause of cancer-related death worldwide, since the majority of patients suffering of this malignancy are usually faced with a poor prognosis due to diagnosis at later stages. In order to improve treatment outcomes, the association of surgery with chemo and/or radiotherapy (multimodal therapy) has become the standard treatment for locally advanced stages. However, despite several treatment options currently available for management of these tumors, perioperative chemotherapy has been mainly accepted for the comprehensive therapeutic strategy including an appropriated D2-gastrectomy. This manuscript presents a (nonsystematic) critical review about the use of perioperative chemotherapy, with a special focus on the drugs delivery.

Stomach neoplasms; Antineoplastic agents; Combined modality therapy; Drug therapy

Trial	n	Regimen	Overral survival	HR (95% CI)	Disease-free survival	HR (95% CI)
Bajetta et al.(⁴4. Bajetta E, Buzzoni R, Mariani L, Beretta E, Bozzetti F, Bordogna G, Aitini E, Fava S, Schieppati G, Pinotti G, Visini M, Ianniello G, Di BM. Adjuvant chemotherapy in gastric cancer: 5-year results of a randomised study by the Italian Trials in Medical Oncology (ITMO) Group. Ann Oncol. 2002;13:299-307.)	274	EAP/FL	52% vs 48% (5y)	0,93 (0.65 – 1.34)	49% vs 44% (5y)	0.83 (0.59 – 1.17)
Nashimoto et al.(⁴¹41. Nashimoto A, Nakajima T, Furukawa H, Kitamura M, Kinoshita T, Yamamura Y, Sasako M, Kunii Y, Motohashi H, Yamamoto S and Gastric Cancer Surgical Study Group, Japan Clinical Oncology Group. Randomized trial of adjuvant chemotherapy with mitomycin, fluorouracil, and cytosine arabinoside followed by oral fluorouracil in serosa-negative gastric cancer: Japan Clinical Oncology Group 9206-1. J Clin Oncol. 2003;21:2282-7.)	252	MFC/F	91.2% vs 86.1% (5y)	-	88.8% vs 83.7% (5y)	-
Chipponi et al.(¹⁴14. Chipponi J, Huguier M, Pezet D, Basso N, Hay JM, Quandalle P, Jaeck D, Fagniez PL, Gainant A. Randomized trial of adjuvant chemotherapy after curative resection for gastric cancer. Am J Surg. 2004;187:440-5.)	205	LFC	39% vs 39% (5y)	-	-	-
Popiela et al.(⁴⁹49. Popiela T, Kulig J, Czupryna A, Szczepanik AM, Zembala M. Efficiency of adjuvant immunochemotherapy following curative resection in patients with locally advanced gastric cancer. Gastric Cancer. 2004;7:240-5.)	156	FAM	30% vs 15,2% (10y)	0,82 (0,65 – 1,01)	-	-
Bouché et al.(⁹9. Bouché O, Ychou M, Burtin P, Bedenne L, Ducreux M, Lebreton G, Baulieux J, Nordlinger B, Martin C, Seitz JF, Tigaud JM, Echinard E, Stremsdoerfer N, Milan C, Rougier P; Fédération Francophone de Cancérologie Digestive Group. Adjuvant chemotherapy with 5-fluorouracil and cisplatin compared with surgery alone for gastric cancer: 7-year results of the FFCD randomized phase III trial (8801). Ann Oncol. 2005;16:1488-97.)	260	CF	46.6% vs 41.9% (5y)	0,74 (0.54 – 1.02)	47.6% vs 39.8% (5y)	0.70 (0.51 – 0.97)
Nitti et al.(⁴²42. Nitti D, Wils J, Dos Santos JG, Fountzilas G, Conte PF, Sava C, Tres A, Coombes RC, Crivellari D, Marchet A, Sanchez E, Bliss JM, Homewood J, Couvreur ML, Hall E, Baron B, Woods E, Emson M, Van Cutsem E, Lise M, EORTC GI Group; ICCG. Randomized phase III trials of adjuvant FAMTX or FEMTX compared with surgery alone in resected gastric cancer. A combined analysis of the EORTC GI Group and the ICCG. Ann Oncol. 2006;17:262-9.)	397	FAMTX or FEMTX	43% vs 44% (5y)	0.98 (0.72 – 1.24)	41% vs 42% (5y)	0.98 (0.72 – 1.24)
De Vita et al.(¹⁸18. De Vita F, Giuliani F, Galizia G, Belli C, Aurilio G, Santabarbara G, Ciardiello F, Catalano G, Orditura M. Neo-adjuvant and adjuvant chemotherapy of gastric cancer. Ann Oncol. 2007;18 Suppl 6:vi120-3.)	228	ELFE	48% vs 43.5% (5y)	0.91 (0.69 – 1,21)	44% vs 39% (5y)	0.88 (0.78 – 0.91)
Nakajima et al.(⁴⁰40. Nakajima T, Kinoshita T, Nashimoto A, Sairenji M, Yamaguchi T, Sakamoto J, Fujiya T, Inada T, Sasako M, Ohashi Y and Group, National Surgical Adjuvant Study of Gastric Cancer. Randomized controlled trial of adjuvant uracil-tegafur versus surgery alone for serosa-negative, locally advanced gastric cancer. Br J Surg. 2007;94:1468-76.)	190	UFT	86% vs 73% (5y)	0.48 (0.26 – 0.89)	85% vs 68% (5y)	0.44 (0.25 – 0.79)
ACTS-GC	1059	S1	71.7% vs 61.1% (5y)	0.66 (0.54 – 0.82)	65.4% vs 53.1% (5y)	0.65 (0.53 – 0.79)
Di Costanzo et al.(¹⁹19. Di Costanzo F, Gasperoni S, Manzione L, Bisagni G, Labianca R, Bravi S, Cortesi E, Carlini P, Bracci R, Tomao S, Messerini L, Arcangeli A, Torri V, Bilancia D, Floriani I, Tonato M, et al. Adjuvant chemotherapy in completely resected gastric cancer: a randomized phase III trial conducted by GOIRC. J Natl Cancer Inst. 2008;100:388-98.)	258	PELF	47.6% vs 48.7% (5y)	0.90 (0.64 – 1.26)	42.3% vs 41.6% (5y)	0.92 (0.65 – 1.27)
Kulig et al.(³²32. Kulig J, Kolodziejczyk P, Sierzega M, Bobrzynski L, Jedrys J, Popiela T, Dadan J, Drews M, Jeziorski A, Krawczyk M, Starzynska T, Wallner G. Adjuvant chemotherapy with etoposide, adriamycin and cisplatin compared with surgery alone in the treatment of gastric cancer: a phase III randomized, multicenter, clinical trial. Oncology. 2010;78:54-61.)	309	EAP	47% vs 40% (5y)	0.74 (0.54 – 1.02)	-	-
CLASSIC	1035	XELOX	83% vs 78% (3y)	0.72 (0.52 – 1.00)	74% vs 59% (3y)	0.56 (0.44 –0.72)

End-point	MAGIC		ACCORD-07
End-point	Multimodal	Surgical	Multimodal	Surgical
5-year Survival	36.3%	23%	38%	24%
Curative or R0 Rates	79.3%	70.3%	87%	74%
pT Rates
T1/T2	51.7%	36.8%	39%	32%
T3/T4	48.3%	63.2%	58%	68%
pN0 Rates	31%	26.9%	33%	20%

Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. Rua Dr. Seng, 320, 01331-020 São Paulo - SP Brasil, Tel./Fax: +55 11 3147-6227 - São Paulo - SP - Brazil
E-mail: secretariaarqgastr@hospitaligesp.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Thales P. Batista. A. Boa Viagem, 5212, ap. 1515 - 51030-000, Recife, PE, Brasil. E-mail: t.paulo@bol.com.br