Effectiveness of Neoadjuvant Chemotherapy With Docetaxel, Cisplatin, and S-1 for Locoregionally Advanced Gastric Adenocarcinoma: Findings From a University Hospital in Vietnam

IF 2.1 4区医学 Q4 ONCOLOGY

Asia-Pacific journal of clinical oncology Pub Date : 2026-09-11 Epub Date: 2025-10-22 DOI:10.1111/ajco.70039

Tho Vinh Tran, Truc Thanh Thai, Loi Ngoc La, Ngon Van Dinh, Vo Duy Long, Bac Hoang Nguyen

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引用次数: 0

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/m²) and cisplatin (35 mg/m²) on days 1 and 15, and oral S-1 (40 mg/m²/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.

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多西紫杉醇、顺铂和S-1新辅助化疗治疗局部进展期胃腺癌的有效性：来自越南一所大学医院的研究结果

目的：评价多西他赛+顺铂+ S-1 （DCS）新辅助治疗方案在局部区域晚期不能切除的胃腺癌患者中的治疗效果，这些患者的特征是肿瘤伴有肿大的区域淋巴结（T1-4a， N-肿大，M0）或T4b肿瘤（任何N， M0）。方法：本研究纳入了78例在越南某大学医院治疗的局部进展期胃腺癌患者，其中47例为回顾性病例，31例为前瞻性病例。患者接受2 - 4个周期的DCS化疗，每个周期包括静脉注射多西他赛（35 mg/m2）和顺铂（35 mg/m2），第1天和第15天，口服S-1 （40 mg/m2/ 2次，每日），第1天至第14天，每4周重复一次。根据患者的反应和耐受性，每3个周期后评估临床治疗反应，并根据患者的反应和耐受性，使用RECIST标准和2 - 4个周期后的增强CT扫描进行重新分期评估。反应良好且分期下降的患者转介行胃切除术。结果：中位年龄58岁，男性占64.1%。新辅助化疗后，T4b肿瘤占比由78.2%下降至52.6%，T4a肿瘤占比由20.5%上升至43.6%。氮体积率由23.1%下降到11.5%。贫血和中性粒细胞减少是最常见的血液学毒性，主要是1-2级。胃肠道毒性和脱发是最常见的临床不良事件，主要为1-2级。新辅助化疗达到客观缓解的65例患者（83.3%）中，42例（53.8%）行胃切除术，R0切除率为92.9%。结论：每4周采用DCS方案的新辅助化疗对局部区域广泛转移的晚期不能切除的胃腺癌患者具有较高的有效性和安全性，增加了其成功切除胃的资格（R0切除术）。试验注册：不适用。本研究为回顾性前瞻性队列研究，非临床试验。

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来源期刊

Asia-Pacific journal of clinical oncology 医学-肿瘤学

CiteScore

3.40

自引率

0.00%

发文量

175

审稿时长

6-12 weeks

期刊介绍： Asia–Pacific Journal of Clinical Oncology is a multidisciplinary journal of oncology that aims to be a forum for facilitating collaboration and exchanging information on what is happening in different countries of the Asia–Pacific region in relation to cancer treatment and care. The Journal is ideally positioned to receive publications that deal with diversity in cancer behavior, management and outcome related to ethnic, cultural, economic and other differences between populations. In addition to original articles, the Journal publishes reviews, editorials, letters to the Editor and short communications. Case reports are generally not considered for publication, only exceptional papers in which Editors find extraordinary oncological value may be considered for review. The Journal encourages clinical studies, particularly prospectively designed clinical trials.