Reichle, Albrecht and Bolder, Ulrich and Bataille, Frauke and Messmann, Helmut and Wagner, H. and Zaiss, M. and Wild, P. and Hofstaedter, Ferdinand and Andreesen, Reinhard and Jauch, K. W. (2003) A multimodal treatment approach including high-dose chemotherapy in very advanced gastric cancer: evidence for control of metastatic disease. BONE MARROW TRANSPLANTATION, 32 (7). pp. 665-671. ISSN 0268-3369
Full text not available from this repository.Abstract
The present multimodal treatment approach was designed to achieve prolonged tumor control in advanced gastric cancer. A total of 26 patients with stage IV gastric cancer (metastatic disease n = 25), ECOG performance status 0-3 and laparoscopically evaluated peritoneal status received a modified EAP schedule to prove chemosensitivity and to mobilize autologous peripheral blood stem cells (aPBSC). Patients without progressive disease proceeded to tandem high-dose chemotherapy (HD-CT) and aPBSCT. Patients with >50% reduction of the target lesion received a second cycle of HD-CT. Responders were selected for local R0 resections (D2 resection) according clinical criteria. Of 26 patients, 20(77%) achieved partial remission after dose-intensive chemotherapy: local R0 resection was achieved in 12 out of 14 patients selected for surgery (46% of all patients). Eight of these R0-resected patients initially had peritoneal carcinomatosis. With a median follow-up of 3.2 years, four patients are still alive. The median overall survival was 8.4 months (CI 2.5-14.4 months), for histologic regression grade 3 (seven out of 25 patients, 28%) 29 months (CI 12-46 months). The combined treatment approach is tolerable and feasible in advanced disease and opens a therapeutic window for a significant proportion of patients, even in cases with histologically proven peritoneal carcinomatosis.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CONTINUOUS-INFUSION 5-FLUOROURACIL; PHASE-II; PREOPERATIVE CHEMOTHERAPY; NEOADJUVANT CHEMOTHERAPY; GASTROINTESTINAL-TRACT; PROGNOSTIC FACTORS; FOLINIC ACID; CISPLATIN; CARCINOMA; TRIAL; advanced gastric cancer; multimodal treatment; neoadjuvant chemotherapy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Lehrstuhl für Pathologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 03 Sep 2021 07:11 |
| Last Modified: | 03 Sep 2021 07:11 |
| URI: | https://pred.uni-regensburg.de/id/eprint/38537 |
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