Docetaxel, Capecitabine and Concurrent Radiotherapy for Gastric Cancer Patients with Postoperative Locoregional Recurrence

Abstract

Aims and background This study aimed to assess the efficacy of concurrent chemoradiotherapy (CCRT) with docetaxel and capecitabine versus docetaxel and capecitabine chemotherapy for gastric cancer patients with postoperative locoregional recurrence. Methods From 2008 to 2011, 81 patients with locoregional recurrence after curative resection of gastric cancer were enrolled. Thirty-nine (CCRT group) received involved-field radiotherapy with oral capecitabine (twice daily, 5 days/week) and intravenous infusion of docetaxel (once weekly). The remaining 42 patients (chemotherapy group) were treated with oral capecitabine (twice daily, days 1-14) followed by intravenous infusion of docetaxel (days 1 and 8). The overall response rate, overall symptom control rate, toxicity or adverse reactions, and overall survival (OS) were compared. Results The overall response rate (CR+PR) was significantly higher in the CCRT group (79.5%) than the chemotherapy group (54.8%). In CCRT individuals, the control rates for bleeding, pain, and dysphagia/obstruction were 87.5%, 75%, and 71.4%, respectively, versus 63.2%, 50%, and 28.6% in the chemotherapy group. CCRT patients had a better symptom control rate than the chemotherapy group (52.5% vs. 80%). Adverse reactions were non-significantly more severe in CCRT patients. Finally, median OS was longer in the CCRT vs. chemotherapy group (14.2 vs. 6.4 months). Conclusions Involved-field radiotherapy with docetaxel and capecitabine was effective and well tolerated. These findings provide further insight into the role of CCRT in gastric cancer. However, this was not a randomized controlled study and the number of patients was relatively small, suggesting that cautious interpretation of cumulative estimates is warranted.