Asia-Pacific journal of clinical oncology
October 22, 2025 · via Europe PMC
Effectiveness of Neoadjuvant Chemotherapy With Docetaxel, Cisplatin, and S-1 for Locoregionally Advanced Gastric Adenocarcinoma: Findings From a University Hospital in Vietnam.
Tran TV, Thai TT, La LN, Van Dinh N, Long VD, Nguyen BH.
AI summary — for doctors, generated from the abstract only
Neoadjuvant docetaxel/cisplatin/S-1 downstaged locoregionally advanced unresectable gastric cancer in a Vietnamese cohort, enabling gastrectomy in 54% with 93% R0 resection.
What was studied
A mixed retrospective (n=47) and prospective (n=31) cohort of 78 patients at a Vietnamese university hospital with T4b or bulky-node gastric adenocarcinoma, treated with 2-4 cycles of DCS.
Key findings
- T4b tumors fell from 78.2% to 52.6%, and bulky nodes from 23.1% to 11.5%
- Objective response in 83.3%
- 42 (53.8%) underwent gastrectomy, with R0 in 92.9%
- Toxicity mostly grade 1-2 hematologic and GI
Clinical relevance
This supports DCS as a conversion strategy to consider in locally advanced unresectable gastric cancer. The study is single-center and has no comparator or survival data.
Who should care
Limitations
Single-center, partly retrospective, no control group, and no survival outcomes reported.
Intensive neoadjuvant chemotherapy can make some unresectable gastric cancers operable.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Aim
To evaluate treatment results of a neoadjuvant regimen consisting of Docetaxel + Cisplatin + S-1 (DCS) in patients with locoregionally advanced unresectable gastric adenocarcinoma characterized by tumors with bulky regional lymph nodes (T1-4a, N-bulky, M0) or T4b tumors (any N, M0)).
Methods
This study included 78 patients with locoregionally advanced gastric adenocarcinoma treated at a university hospital in Vietnam, comprising 47 retrospective and 31 prospective cases. Patients received 2 - 4 cycles of DCS chemotherapy, with each cycle comprising intravenous docetaxel (35 mg/m2) and cisplatin (35 mg/m2) on days 1 and 15, and oral S-1 (40 mg/m2/twice daily) from days 1 to 14, repeated every 4 weeks. Clinical treatment response was assessed after every three cycles and re-staging evaluation by using the RECIST criteria and contrast-enhanced CT scans after 2 - 4 cycles, depending on patient response and tolerability. Patients with a good response and down-staging were referred for gastrectomy.
Results
The median age was 58 years, and 64.1% were male. Following neoadjuvant chemotherapy, the proportion of T4b tumors decreased from 78.2% to 52.6%, while T4a tumors increased from 20.5% to 43.6%. The rate of N-bulky decreased from 23.1% to 11.5%. Anemia and neutropenia were the most common hematological toxicities, predominantly grade 1-2. Gastrointestinal toxicity and hair loss were the most frequent clinical adverse events, mostly grade 1-2. Among 65 patients (83.3%) achieving an objective response to neoadjuvant chemotherapy, 42 (53.8%) underwent gastrectomy, with R0 resection achieved in 92.9%.
Conclusion
Neoadjuvant chemotherapy using the DCS regimen every 4 weeks demonstrated high effectiveness and safety in patients with locoregionally advanced unresectable gastric adenocarcinoma characterized by extensive regional metastases, and increased their eligibility for successful gastrectomy (R0 resection).
Trial registration
This study is a retrospective and prospective cohort study, not a clinical trial.
DOI
10.1111/ajco.70039
PMID
41122959
PMCID
PMC13569072
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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