Gastrointestinal Cancer

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SU_11_2115 - A Prospective Phase I Study of Hypo-Fractionated Neoadjuvant Radiation Therapy for Locally Advanced Gastric Cancer

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

A Prospective Phase I Study of Hypo-Fractionated Neoadjuvant Radiation Therapy for Locally Advanced Gastric Cancer
N. Li1, J. Jin1, Y. Tang2, X. Wang3, W. Liu Jr2, N. Lu3, H. Fang1, B. Chen4, S. Qi1, Y. Liu2, S. Wang5, and Y. Li6; 1State Key Laboratory of Molecular Oncology and Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China, 2Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, 3National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, 4Radiation Oncology Department ,National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences(CAMS) and Peking Union Medical College(PUMC), Beijing, China, 5National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China, 6Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China, Beijing, China

Purpose/Objective(s): This study sought to assess the maximum tolerated dose (MTD) and dose-limited toxicity (DLT) of hypo-fractionated chemoradiotherapy for local advanced gastric cancer.

Materials/Methods: Patients with cT3-4 and/or lymph node-positive locally advanced gastric cancer or Siewert II/III esophagogastric junction adenocarcinoma were enrolled. Preoperative chemoradiation was followed by 3 cycles of oxaliplatin + S-1 neoadjuvant chemotherapy with an interval duration of 3-4 weeks. D2 resection was performed 2-4 weeks after neoadjuvant therapy. Three cycles of adjuvant chemotherapy were planned after surgery. Intensity-modulated radiotherapy (IMRT) was used. The radiotherapy dose level was defined using three levels, namely, 40.0 Gy/2.5 Gy, 41.6 Gy/2.6 Gy, 43.2 Gy/2.7 Gy delivered concurrently with S-1 at 80 mg/m2.

Results: From May 2016 to Dec 2016, nine patients with a median age of 63 years were enrolled in this study. The most common grade I-III adverse events were leukopenia (88.9%), nausea (88.9%), vomiting (77.8%) and weight loss (66.7%). Grade III adverse events consisted of vomiting and weight loss.

Conclusion: The MTD of hypo-fractionated radiotherapy for locally advanced gastric cancer was 40.0 Gy/2.5 Gy, and the DLTs were vomiting and weight loss.
Dose level Dose n Number of DLT DLT Radiotherapy dose when DLT
1 40 Gy/2.5 Gy 3 0 - -
2 41.6 Gy/2.6 Gy 6 2 Vomiting 31.2 Gy
Weight loss 41.6 Gy

Author Disclosure: N. Li: None. J. Jin: None. Y. Tang: None.

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