AUTHOR=Wang Xin , Zhao Dong-Bing , Yang Lin , Chi Yihebali , Zhao Hong , Jiang Li-Ming , Jiang Jun , Tang Yuan , Li Ning , Liu Wen-Yang , Dou Li-Zhou , Zou Shuang-Mei , Xue Li-Yan , Ren Jian-Song , Tian Yan-Tao , Che Xu , Guo Chun-Guang , Bai Xiao-Feng , Sun Yue-Min , Wang Shu-Lian , Song Yong-Wen , Liu Yue-Ping , Fang Hui , Li Ye-Xiong , Jin Jing 

TITLE=Preoperative Concurrent Chemoradiotherapy Versus Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer: Phase II Randomized Study

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.870741

DOI=10.3389/fonc.2022.870741

ISSN=2234-943X

ABSTRACT=Abstract
Objective: We evaluated and compared the efficacy and safety of neoadjuvant chemoradiotherapy (NACRT) versus neoadjuvant chemotherapy (NACT) for locally advanced gastric cancer (LAGC) in a single-center randomized phase II trial. 
Methods: Patients with LAGC were enrolled and received either NACT or NACRT, followed by gastrectomy and adjuvant chemotherapy. The primary endpoint was an R0 resection rate. 
Results: We enrolled 75 patients: 75.7% (NACT, 28/37 patients) and 76.3% (NACRT, 29/38 patients) underwent surgery; R0 resection rates were 73.0% (27/37) and 73.7% (28/38), respectively. The NACRT group had significantly better major pathological response than the NACT group (37.9% vs 17.9%, p = 0.019). Between-group postoperative complications were not significantly different. The median follow-up was 59.6 months; 5-year overall survival (OS) rate was 50.1% (NACT) and 61.9% (NACRT); neither group reached the median OS; median progression-free survival was 37.3 and 63.4 months, respectively. 
Conclusions: S-1-based NACRT did not improve the R0 resection rate, although it presented better tumor regression with similar safety to NACT.