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Predicate | Object |
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rdf:type | |
lifeskim:mentions |
umls-concept:C0008838,
umls-concept:C0013216,
umls-concept:C0016360,
umls-concept:C0205179,
umls-concept:C0205195,
umls-concept:C0282460,
umls-concept:C0348016,
umls-concept:C0549178,
umls-concept:C0600558,
umls-concept:C1511237,
umls-concept:C1517927,
umls-concept:C1550436,
umls-concept:C1704242,
umls-concept:C1705509
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pubmed:issue |
9
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pubmed:dateCreated |
1995-1-24
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pubmed:abstractText |
Locally advanced gastric adenocarcinomas (LAGC) have a poor prognosis, particularly when tumours are bulky, located in the cardia or in the event of locoregional lymph node involvement. Patients bearing these tumours were entered in a phase II trial of neoadjuvant chemotherapy, combining continuous intravenous 5-fluorouracil (5FU) (1000 mg/m2 for 5 days) and cisplatinum (CDDP) (100 mg/m2 on day 2) repeated every 4 weeks, for one to six cycles according to response and tolerance. 30 patients have been entered, 26 after clinical evaluation (CAT scan and upper gastrointestinal endoscopy) and 4 with unresectable tumours at prior laparotomy. Median age was 60 years, 15/30 patients had a tumour of the cardia, 15/30 had enlarged lymph nodes and 7/30 had linitis plastica (diffuse type). A mean number of three cycles was administered (range 1-6). 27 of the 30 patients were evaluable for response. One patient achieved a complete response (CR) and 14 a partial response (56%; 95% confidence interval 38-74%). No patient had tumour progression, and only 1/6 with linitis plastica responded. 28 patients underwent surgery, and 23 had a macroscopically complete resection (77% of the 30 entered patients); RO resections were performed in 60% of the cases, mainly after an objective response (13/15 versus 4/12 in nonresponders). No pathological CR were seen. Grade 4 neutropenia was observed in eight cycles (5 patients), with five septic complications and one death due to toxicity. Four postoperative complications were observed: 2 cases of severe pneumonia and 2 subphrenic abscesses. One postoperative death, due to intravascular disseminated coagulation, was observed at day 30. Median survival was 16 months and the 1-, 2- and 3-year survival was 67, 42 and 38%, respectively. Patients with linitis plastica had a significantly shorter survival (P < 0.002). We conclude that neodjuvant chemotherapy is feasible in LAGC, although randomised trials are warranted to demonstrate its efficacy on survival and resection rates.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:issn |
0959-8049
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
30A
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pubmed:owner |
NLM
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pubmed:authorsComplete |
N
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pubmed:pagination |
1269-75
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pubmed:dateRevised |
2006-4-24
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pubmed:meshHeading |
pubmed-meshheading:7999411-Adult,
pubmed-meshheading:7999411-Aged,
pubmed-meshheading:7999411-Antineoplastic Combined Chemotherapy Protocols,
pubmed-meshheading:7999411-Chemotherapy, Adjuvant,
pubmed-meshheading:7999411-Cisplatin,
pubmed-meshheading:7999411-Disease-Free Survival,
pubmed-meshheading:7999411-Female,
pubmed-meshheading:7999411-Fluorouracil,
pubmed-meshheading:7999411-Humans,
pubmed-meshheading:7999411-Male,
pubmed-meshheading:7999411-Middle Aged,
pubmed-meshheading:7999411-Prospective Studies,
pubmed-meshheading:7999411-Stomach Neoplasms,
pubmed-meshheading:7999411-Time Factors,
pubmed-meshheading:7999411-Treatment Outcome
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pubmed:year |
1994
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pubmed:articleTitle |
Neoadjuvant chemotherapy in locally advanced gastric carcinoma--a phase II trial with combined continuous intravenous 5-fluorouracil and bolus cisplatinum.
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pubmed:affiliation |
Gastro-Intestinal Unit, Institut Gustave Roussy, Villejuif, France.
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pubmed:publicationType |
Journal Article,
Clinical Trial,
Clinical Trial, Phase II
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