Long-term clinical outcomes of patients with locally advanced gastric adenocarcinoma after two induction cycles of chemotherapy according to the FLOT regimen followed by chemoradiotherapy and radical surgery

In recent years, the possibility of neoadjuvant treatment of patients with locally advanced gastric cancer (GC) has been actively studied. One of the proposed directions is the addition of radiation therapy. In order to increase the frequency of the tumor response and radical (R0) resections, to achieve a greater degree of pathological response, reduce the “yp” stage and, finally, to improve long-term results. Objective. Study of treatment results in patients with locally advanced GC through 2 induction cycles of chemotherapy according to FLOT scheme followed by chemoradiotherapy and radical surgery. Material and methods. A total of 47 patients with locally advanced GC were included. Stage III GC was diagnosed in 27 patients, stage II occurred in 18 patients and stage IV — in 2 patients. High-grade adenocarcinoma was detected in 7 patients, moderate — 13 and low-grade in 23 patients; in 4 cases, signet ring cell adenocarcinoma was occurred. The surgery was attended in 45 patients, in 44 (93.6%) cases was performed radical (R0) surgical treatment. Results. The three-year overall and recurrence-free survival rate were 74.4±6.5% and 60.1±7.0%, respectively. In comparison with randomized and large retrospective studies by foreign authors, the indicators of treatment completion, the degree of pathological response and long-term results in our study were higher. Conclusion. Two cycles of FLOT, followed by chemoradiotherapy and radical surgery in patients with locally advanced GC, are associated by a high percentage of treatment completion and cases of radical surgery, pronounced clinical and pathologic response and high rates of three-year overall and disease-free survival. © 2025 Elsevier B.V., All rights reserved.