An Analysis of Tolerance and Early Survival Outcomes with Perioperative Modified FLOT in Gastric Cancers
Abstract Anant Ramaswamy Purpose Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT) is a current standard of care for locoregionally advanced gastric adeno...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2022-04-01
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| Series: | South Asian Journal of Cancer |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1733349 |
| _version_ | 1797987269768904704 |
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| author | Prabhat Bhargava Sudeep Das Vikas Ostwal Sujay Srinivas Manish Bhandare Vikram Chaudhari Munita Bal Anoop Mantri Akhil Kapoor Shailesh V. Shrikhande Anant Ramaswamy |
| author_facet | Prabhat Bhargava Sudeep Das Vikas Ostwal Sujay Srinivas Manish Bhandare Vikram Chaudhari Munita Bal Anoop Mantri Akhil Kapoor Shailesh V. Shrikhande Anant Ramaswamy |
| author_sort | Prabhat Bhargava |
| collection | DOAJ |
| description | Abstract
Anant Ramaswamy
Purpose Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT) is a current standard of care for locoregionally advanced gastric adenocarcinomas. There is limited real world data with regard to the tolerance and efficacy of this regimen.
Materials and Methods This is a retrospective analysis of gastric cancer patients who were offered neoadjuvant perioperative modified FLOT regimen between December 2016 and October 2018, at the Tata Memorial Hospital, Mumbai. Chemotherapy-related side-effects are reported along with overall survival (OS), as calculated by Kaplan-Meier method.
Results Three hundred and forty-three consecutive patients were started on neoadjuvant chemotherapy (NACT) with mFLOT of which 298 patients (87%) completed the planned treatment. A total of 294 patients (86%) underwent curative resection of gastric cancer. Common grade 3 and grade 4 toxicities during NACT were diarrhea in 42 patients (12%) and febrile neutropenia in 27 patients (8%). Toxic death was seen in nine (2.6%) patients. A total of 264 patients (77%) completed planned adjuvant chemotherapy. Common grade 3 and grade 4 toxicities during adjuvant therapy were diarrhea in 42 patients (12%) and febrile neutropenia in 16 patients (6%). With a median follow-up of 19 months, the estimated 2-year median OS was 69.4%.
Conclusion Administration of modified FLOT regimen in locoregionally advanced gastric cancers is feasible in clinical practice with high completion rates, though requiring dose modifications due to the incidence of clinically relevant grade 3 to 5 toxicities. Early outcomes with the regimen are on par with survivals from the FLOT-AIO study. |
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| issn | 2278-330X 2278-4306 |
| language | English |
| last_indexed | 2024-04-11T07:45:15Z |
| publishDate | 2022-04-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
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| series | South Asian Journal of Cancer |
| spelling | doaj.art-8e964f3d13e84c8f8df9909c0c6a556d2022-12-22T04:36:19ZengThieme Medical and Scientific Publishers Pvt. Ltd.South Asian Journal of Cancer2278-330X2278-43062022-04-01110211211710.1055/s-0041-1733349An Analysis of Tolerance and Early Survival Outcomes with Perioperative Modified FLOT in Gastric CancersPrabhat Bhargava0Sudeep Das1Vikas Ostwal2Sujay Srinivas3Manish Bhandare4Vikram Chaudhari5Munita Bal6Anoop Mantri7Akhil Kapoor8Shailesh V. Shrikhande9Anant Ramaswamy10Department of Medical Oncology, Homi Bhabha National Institute (HBNI), Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Medical Oncology, Homi Bhabha National Institute (HBNI), Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Medical Oncology, Homi Bhabha National Institute (HBNI), Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Medical Oncology, Homi Bhabha National Institute (HBNI), Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Gastrointestinal and HPB Surgery, Homi Bhabha National Institute (HBNI), Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Gastrointestinal and HPB Surgery, Homi Bhabha National Institute (HBNI), Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Pathology, Homi Bhabha National Institute (HBNI), Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Medical Oncology, Homi Bhabha National Institute (HBNI), Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Medical Oncology, Homi Bhabha National Institute (HBNI), Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Gastrointestinal and HPB Surgery, Homi Bhabha National Institute (HBNI), Tata Memorial Hospital, Mumbai, Maharashtra, IndiaDepartment of Medical Oncology, Homi Bhabha National Institute (HBNI), Tata Memorial Hospital, Mumbai, Maharashtra, IndiaAbstract Anant Ramaswamy Purpose Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT) is a current standard of care for locoregionally advanced gastric adenocarcinomas. There is limited real world data with regard to the tolerance and efficacy of this regimen. Materials and Methods This is a retrospective analysis of gastric cancer patients who were offered neoadjuvant perioperative modified FLOT regimen between December 2016 and October 2018, at the Tata Memorial Hospital, Mumbai. Chemotherapy-related side-effects are reported along with overall survival (OS), as calculated by Kaplan-Meier method. Results Three hundred and forty-three consecutive patients were started on neoadjuvant chemotherapy (NACT) with mFLOT of which 298 patients (87%) completed the planned treatment. A total of 294 patients (86%) underwent curative resection of gastric cancer. Common grade 3 and grade 4 toxicities during NACT were diarrhea in 42 patients (12%) and febrile neutropenia in 27 patients (8%). Toxic death was seen in nine (2.6%) patients. A total of 264 patients (77%) completed planned adjuvant chemotherapy. Common grade 3 and grade 4 toxicities during adjuvant therapy were diarrhea in 42 patients (12%) and febrile neutropenia in 16 patients (6%). With a median follow-up of 19 months, the estimated 2-year median OS was 69.4%. Conclusion Administration of modified FLOT regimen in locoregionally advanced gastric cancers is feasible in clinical practice with high completion rates, though requiring dose modifications due to the incidence of clinically relevant grade 3 to 5 toxicities. Early outcomes with the regimen are on par with survivals from the FLOT-AIO study.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1733349flotgastric cancertolerancetoxicityneoadjuvantadjuvant |
| spellingShingle | Prabhat Bhargava Sudeep Das Vikas Ostwal Sujay Srinivas Manish Bhandare Vikram Chaudhari Munita Bal Anoop Mantri Akhil Kapoor Shailesh V. Shrikhande Anant Ramaswamy An Analysis of Tolerance and Early Survival Outcomes with Perioperative Modified FLOT in Gastric Cancers South Asian Journal of Cancer flot gastric cancer tolerance toxicity neoadjuvant adjuvant |
| title | An Analysis of Tolerance and Early Survival Outcomes with Perioperative Modified FLOT in Gastric Cancers |
| title_full | An Analysis of Tolerance and Early Survival Outcomes with Perioperative Modified FLOT in Gastric Cancers |
| title_fullStr | An Analysis of Tolerance and Early Survival Outcomes with Perioperative Modified FLOT in Gastric Cancers |
| title_full_unstemmed | An Analysis of Tolerance and Early Survival Outcomes with Perioperative Modified FLOT in Gastric Cancers |
| title_short | An Analysis of Tolerance and Early Survival Outcomes with Perioperative Modified FLOT in Gastric Cancers |
| title_sort | analysis of tolerance and early survival outcomes with perioperative modified flot in gastric cancers |
| topic | flot gastric cancer tolerance toxicity neoadjuvant adjuvant |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1733349 |
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