Evaluation of Pathological Response Rate and Complications of FOLFOX versus FLOT Regimen in Perioperative Chemotherapy for Resectable Gastric Cancer: A Prospective Study.
FLOT regimen
FOLFOX regimen
Gastric cancer
Perioperative chemotherapy
Journal
Asian Pacific journal of cancer prevention : APJCP
ISSN: 2476-762X
Titre abrégé: Asian Pac J Cancer Prev
Pays: Thailand
ID NLM: 101130625
Informations de publication
Date de publication:
01 Aug 2023
01 Aug 2023
Historique:
received:
07
04
2023
medline:
31
8
2023
pubmed:
29
8
2023
entrez:
29
8
2023
Statut:
epublish
Résumé
Previous studies have shown that the perioperative and postoperative chemotherapy can lead to an improvement in the prognosis of patients with resectable gastric cancer (GC). There is no preference for postoperative chemotherapy with the two common treatment regimens, FLOT and FOLFOX, in these patients. The aim of this study was to compare FOLFOX and FLOT regimens in perioperative chemotherapy in resectable GC based on pathological response and complications. This prospective cohort study was conducted on 112 patients with resectable GC who were admitted to Firozgar Hospital affiliated with Iran University of Medical Sciences, Tehran, Iran between 2021 to 2022. Given the inclusion criteria, 80 patients were enrolled in the present study. Patients were divided into 2 groups based on the type of treatment regimen, FOLFOX (40 patients) and FLOT (40 patients). Tumor response was classified using Mandard Tumor regression grading system criteria into five categories of TRG1 to 5. Also, the side effects were classified according to the National Cancer Institute Common Toxicity Criteria for Adverse Events (CTCAE) version 5.0. The rate of complete pathological response in FOLT group was significantly higher than FOLFOX group (35.0% vs 2.5%, p: 0.001). The frequency of neurological complications and hair loss in the FOLT group was significantly higher than the FOLFOX group (P<0.05). While no significant difference was observed in the frequency of hematological, Gastroenterological, hepatic, renal and stomatitis complications in the both groups (p>0.05). Our study showed that perioperative FLOT regimen has a better pathological response than FOLFOX regimen. The frequency of neurological complications and hair loss was significantly higher in patients treated with FLOT regimen. Thus, perioperative FLOT regimen may be recommended for treating GC patients.
Sections du résumé
BACKGROUND
BACKGROUND
Previous studies have shown that the perioperative and postoperative chemotherapy can lead to an improvement in the prognosis of patients with resectable gastric cancer (GC). There is no preference for postoperative chemotherapy with the two common treatment regimens, FLOT and FOLFOX, in these patients. The aim of this study was to compare FOLFOX and FLOT regimens in perioperative chemotherapy in resectable GC based on pathological response and complications.
METHODS
METHODS
This prospective cohort study was conducted on 112 patients with resectable GC who were admitted to Firozgar Hospital affiliated with Iran University of Medical Sciences, Tehran, Iran between 2021 to 2022. Given the inclusion criteria, 80 patients were enrolled in the present study. Patients were divided into 2 groups based on the type of treatment regimen, FOLFOX (40 patients) and FLOT (40 patients). Tumor response was classified using Mandard Tumor regression grading system criteria into five categories of TRG1 to 5. Also, the side effects were classified according to the National Cancer Institute Common Toxicity Criteria for Adverse Events (CTCAE) version 5.0.
RESULTS
RESULTS
The rate of complete pathological response in FOLT group was significantly higher than FOLFOX group (35.0% vs 2.5%, p: 0.001). The frequency of neurological complications and hair loss in the FOLT group was significantly higher than the FOLFOX group (P<0.05). While no significant difference was observed in the frequency of hematological, Gastroenterological, hepatic, renal and stomatitis complications in the both groups (p>0.05).
CONCLUSION
CONCLUSIONS
Our study showed that perioperative FLOT regimen has a better pathological response than FOLFOX regimen. The frequency of neurological complications and hair loss was significantly higher in patients treated with FLOT regimen. Thus, perioperative FLOT regimen may be recommended for treating GC patients.
Identifiants
pubmed: 37642066
doi: 10.31557/APJCP.2023.24.8.2791
pmc: PMC10685210
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2791-2797Références
J Clin Gastroenterol. 2015 May-Jun;49(5):387-94
pubmed: 25144898
J Gastrointest Surg. 2021 Jan;25(1):58-66
pubmed: 32040809
J Gastroenterol Hepatol. 2020 Sep;35(9):1495-1502
pubmed: 32181516
Asian Pac J Cancer Prev. 2020 Aug 01;21(8):2337-2341
pubmed: 32856863
Res Pharm Sci. 2022 Oct 29;17(6):621-634
pubmed: 36704436
World J Surg Oncol. 2011 Sep 26;9:110
pubmed: 21942969
Eur J Cancer. 2019 Jan;107:46-52
pubmed: 30529902
Cancers (Basel). 2019 Mar 21;11(3):
pubmed: 30901943
N Engl J Med. 2006 Jul 6;355(1):11-20
pubmed: 16822992
Br J Cancer. 2016 Jun 14;114(12):1326-33
pubmed: 27172250
Clin Gastroenterol Hepatol. 2020 Mar;18(3):534-542
pubmed: 31362118
Lancet. 2019 May 11;393(10184):1948-1957
pubmed: 30982686
J Surg Oncol. 2020 Apr;121(5):833-839
pubmed: 31943232
Cancer Manag Res. 2019 Apr 10;11:3009-3020
pubmed: 31114348
Exp Ther Med. 2014 Feb;7(2):461-467
pubmed: 24396426
Zhonghua Wai Ke Za Zhi. 2009 Sep 1;47(17):1305-8
pubmed: 20092724
J Clin Oncol. 2010 Dec 10;28(35):5210-8
pubmed: 21060024
J Cancer Res Ther. 2023 Jan-Mar;19(2):253-258
pubmed: 37006064
J Clin Oncol. 2004 Feb 15;22(4):658-63
pubmed: 14966088
BMC Cancer. 2022 May 12;22(1):537
pubmed: 35549674
CA Cancer J Clin. 2005 Mar-Apr;55(2):74-108
pubmed: 15761078
BMC Surg. 2020 Jul 13;20(1):152
pubmed: 32660458
Int J Clin Oncol. 2019 Jun;24(6):614-623
pubmed: 30919257
Eur J Cancer. 2021 Mar;145:158-167
pubmed: 33485079